From AVM to cavernoma: the long-term effects of stereotactic radiosurgery

Radiation-induced cavernomas are rare but significant late complications of stereotactic radiosurgery (SRS) for arteriovenous malformations (AVMs). We report the case of a 66-year-old male who developed a contrast-enhancing lesion with cystic necrosis and perilesional edema in the left frontal lobe, 12 years after SRS following transarterial embolization for a partially calcified AVM. Digital subtraction angiography showed no AVM recurrence. Due to progressive anomic aphasia, decreased concentration and reduced initiative, a surgical resection was performed. This confirmed a radiation-induced cavernoma. This case underscores the need for long-term follow-up with multimodal imaging to differentiate late radiation-induced vascular lesions from recurrent pathology. Continuous clinical assessment is crucial for timely intervention, as delayed radiation effects can impact neurological function and patient outcomes.