• headache;
  • gamma knife surgery;
  • stereotactic radiosurgery;
  • arteriovenous malformation;
  • nigraine

Gamma knife surgery has become an effective alternative to microsurgery in the treatment of cerebral arteriovenous malformations. In a number of patients, a de novo headache syndrome has been produced after gamma knife surgery. A case report is presented of a 62-year-old man who developed a migrainous type headache 15 months after gamma knife surgery. The current neurosurgical literature has very poor documentation of postsurgical headaches. A review of the literature was made to try to identify a stereotypic “post gamma knife headache,” as well as hypothesize about its mechanism of induction.