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Intracranial hemorrhage during GliaSite RTS manipulation in an anticoagulated patient

Published online by Cambridge University Press:  01 March 2007

David E. Gerber ,
Stuart A. Grossman ,
Timothy A. Chan  and
Lawrence Kleinberg
David E. Gerber
Affiliation:
Department of Oncology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD 21231, USA
Stuart A. Grossman*
Affiliation:
Department of Oncology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD 21231, USA Department of Neurosurgery, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD 21231, USA Department of Medicine, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD 21231, USA
Timothy A. Chan
Affiliation:
Department of Radiation Oncology and Molecular Radiation Sciences, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD 21231, USA
Lawrence Kleinberg
Affiliation:
Department of Radiation Oncology and Molecular Radiation Sciences, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD 21231, USA
*
Correspondence to: Stuart A. Grossman, MD, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, 1550 Orleans Street, CRB II, suite 1M-16, Baltimore, MD 21231, USA. E-mail: [email protected]
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Abstract

The GliaSite radiation therapy system (RTS) is an implantable balloon brachytherapy applicator used to deliver iodine-125 in the treatment of recurrent high-grade gliomas. Patients generally tolerate the procedure well, with only rare reports of adverse events such as wound infection, meningitis, and symptomatic radiation necrosis. Hemorrhagic complications have not been reported. We present a case report describing intracranial hemorrhage during GliaSite manipulation in a patient receiving long-term anticoagulation for a previously diagnosed pulmonary embolism. The GliaSite RTS and the management of venous thromboembolism in patients with brain tumors are reviewed. These events suggest that normalizing coagulation status during GliaSite balloon inflation and deflation should be considered.

Keywords

Glioblastoma multiformeVenous thromboembolismAnticoagulationIntracranial hemorrhageGilaSite RTSBrachytherapy
Type
Case Study
Information
Journal of Radiotherapy in Practice , Volume 6 , Issue 1 , March 2007 , pp. 53 - 57
Copyright
Copyright © Cambridge University Press 2007

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