Radiation-induced leukoencephalopathy and cerebral vasculopathy

Case contributed by A.Prof Frank Gaillard

Presentation

Presents with progressive brainstem signs

Patient Data

Age: 60 years
Gender: Male

Prior history of nasopharyngeal carcinoma and bone marrow changes within the base of skull and upper cervical spine in keeping with prior radiotherapy. Numerous microhemorrhages also conform to prior radiotherapy, located in the cerebellum, brainstem and temporal poles. This is associated with high T2 signal within the temporal poles further suggestive of a radiotherapy induced leukoencephalopathy. The pons and midbrain demonstrate multiple infarcts with volume loss, presumably also the sequelae of a radiotherapy. Supratentorially, other than the temporal lobes, there is relatively little chronic small vessel ischemic change with a solitary corona radiata infarct on the left. Ventricles are mildly prominent. No intra extra-axial mass or abnormal contrast enhancement.

Conclusion: Extensive change secondary to radiotherapy for nasopharyngeal carcinoma.

Case Discussion

This patient had received radiotherapy for a nasopharyngeal carcinoma over 15 years previously. 

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Case information

rID: 64589
Published: 2nd Dec 2018
Last edited: 2nd Dec 2018
Inclusion in quiz mode: Included

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