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Vol. 20. Issue 5.
Pages 449-453 (January 2009)
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Vol. 20. Issue 5.
Pages 449-453 (January 2009)
Eficacia del oxígeno hiperbárico en el tratamiento de la radionecrosis y el edema cerebral sintomáticos tras radiocirugía con acelerador lineal
Usefulness of hyperbaric oxygen in the treatment of radionecrosis and symptomatic brain edema after LINAC radiosurgery
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M.A. Pérez-Espejo, M. Felipe-Murcia, J.F. Martínez-Lage
Servicios de Neurocirugía. Hospital Universitario “Virgen Arrixaca”
R. García-Fernández*, I. De la Fuente-Muñoz*, J. Salinas-Ramos*, J. Fernández-Pérez*
* Oncología Radioterápica. Hospital Universitario “Virgen Arrixaca”
B.M. Tobarra-González**, J.D. Palma-Copete**, A. González-López**
** Radiofísica y Protección Radiológica. Hospital Universitario “Virgen Arrixaca”
J.M. Romero***
*** Murcia. Cámara hiperbárica de Cartagena. Hospital de Caridad. Cartagena. Murcia. España
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Resumen

La radionecrosis y el edema cerebral son complicaciones asociadas a la radiocirugía. Presentamos los casos de tres pacientes tratadas con radiocirugía mediante acelerador lineal, de un meningioma de polo frontal izquierdo, peñasco y parasagital parietooccipital, respectivamente, que desarrollaron, entre dos y ocho meses más tarde, lesiones de tipo radionecrótico con extenso edema peritumoral que resultaron resistentes al tratamiento con esteroides y que se han resuelto con la administración de 40 sesiones de oxígeno hiperbárico. Son pocos los casos publicados hasta ahora en la literatura con tan excelentes resultados, por lo que consideramos un hecho a tener muy en cuenta ante las posibles complicaciones de este tipo que puedan presentarse en el transcurso de la práctica radioquirúrgica antes de recurrir a la cirugía.

Palabras clave:
Radiocirugía
Radionecrosis
Oxígeno hiperbárico
Edema cerebral
Acelerador lineal
Summary

Radionecrosis with brain edema is a complication of radiosurgery. Three female patients harbouring a frontal pole, petrous and parasagital parietoocipital meningiomas respectively who had been treated with LINAC radiosurgery are presented. Those patients developed, between two and eight months later, a severe symptomatic radionecrosis with a huge brain edema resistant to the usual steroid therapy. Only after 40 sessions of hyperbaric oxygen, a good remission of the lesions was obtained. There are few cases reported in the literature with such a good outcome. Consequentely, this therapy must be taken into account to treat this type of radiosurgical complication before considering surgery.

Key words:
Radiosurgery
Radionecrosis
Hyperbaric oxygen
Brain edema
LINAC

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