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Haemorrhage was identified in 7.4% of the metastases (five tumours in four patients) before radiosurgery and in 18.5% (10 tumours in 10 patients) after radiosurgery. In three cases, haemorrhage into the tumour after radiosurgery was symptomatic. Half the haemorrhages occurred within one month of radiosurgery. The changes in tumour size observed at the time of haemorrhage were an increase in one tumour, no change in five, and a decrease in four. Haemorrhage into a tumour after radiosurgery was more likely to occur in female patients, in tumours with a larger volume on pretreatment neuroimaging, and in tumours treated with a larger number of isocentres of a higher maximum dose. Haemorrahgic features in the patients or their tumours on presurgical assessment were not disposing factors to haemorrhage after radiosurgery. When larger brain metastases are aggressively treated by radiosurgery, better local control may be attained but there may also be a higher risk of haemorrhage soon after the treatment. |
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iatrogenic neurologic disorders
intracerebral hemorrhage
linear accelerator
neoplasm,metastatic to CNS
neoplasm,metastatic to CNS,hemorrhagic
neoplasm,metastatic to CNS-hemorrhage into
radiation therapy,CNS treatment and complications with
radiation therapy,stereotactic
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