Radiation-Induced Geometric Alopecia Following Cerebral AVM Embolization: A Case Report

Radiation-induced alopecia is a recognized but underreported complication of fluoroscopy-guided neurointerventional procedures. A 46-year-old male presented with a new-onset generalized tonic–clonic seizure and was diagnosed with a right temporal arteriovenous malformation, Spetzler–Martin Grade III. He underwent diagnostic digital subtraction angiography followed by endovascular embolization using Onyx. Approximately 60 to 70% nidus obliteration was achieved. Two to three weeks post-procedure, he developed a well-defined geometric alopecic patch over the occipito-parietal scalp corresponding to the radiation field, without inflammatory changes. The peak skin dose was 1.8 Gy, and the total dose area product was 120 Gy·cm2. Findings were consistent with radiation-induced alopecia. The patient was managed conservatively with reassurance and topical therapy, with expected spontaneous regrowth. Radiation-induced alopecia may occur even at lower-than-expected radiation doses. Awareness of radiation exposure parameters and preventive strategies is essential in neurointerventional practice.