Massive Radionecrosis vs Pseudoinflammation After Radiosurgical Corpus Callosotomy in a Patient With Drug-Resistant Epilepsy

Radiosurgery (RS) has proven to be an effective alternative for the treatment of intracranial neoplasms, arteriovenous malformations, and functional conditions such as epilepsy. Regarding the latter, palliative epilepsy surgery involving corpus callosum disconnection by RS has been shown to be as effective as its surgical counterpart in terms of seizure reduction. However, adverse effects derived from radiation-induced neurotoxicity in the target area may occasionally occur, with radionecrosis (RN) being one of the main causes of morbidity after RS. This paper presents the case of a female patient diagnosed with refractory epilepsy who developed an extensive heterogeneous lesion evident on MRI studies months after undergoing callosotomy by RS.