Pathological Changes in Surgically Resected Cystic Cerebral Cavernous Malformation 13 Years After Radiosurgery - Case Report and Literature Review.

Abstract Background Stereotactic radiosurgery (SRS) as a treatment of cerebral cavernous malformation (CCM) has been controversial, but there are few pathological reports showing its long-term therapeutic effect. And the literature reporting the CCM cyst formation after SRS is also rare. Case Description We present a 30-year-old female with a ruptured right parietal CCM treated with SRS 13 years ago. The post-SRS imaging follow-up revealed CCM rehemorrhage and cyst formation. Surgical resection was performed, and a subsequent pathological examination revealed that the CCM still had some incomplete occluded vessels and a large number of newly formed capillaries, and hemorrhagic band and hemosiderin were seen around the nodule. Conclusions Recurrent hemorrhage after SRS for CCM could be related to incomplete occluded vessels and newly formed capillaries. Repeat newly formed capillaries hemorrhage of CCM into the small cavity increased the osmotic pressure, which caused the increased size of the cyst.