Citation, DOI and case data
History of meningioma resection 20 years ago and treated with radiotherapy. Headache and visual disturbances of 3 weeks of evolution
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Prominent right occipital and parietal lobes cortical thickening and hyperintensity on axial FLAIR and T2 image with gyriform enhancement on T1W image after gadolinium administration without respecting vascular territories. No diffusion restriction.
Biparietal postsurgical encephalomalacia.
In this context, the findings are considered compatible with SMART syndrome (stroke-like migraine attacks after radiation therapy). SMART syndrome is an infrequent late complication of radiation therapy that has been linked to microvascular dysfunction.
Symptoms and brain MRI abnormalities tend to be transient.
- 1. D.F. Black, J.M. Morris, E.P. Lindell, K.N. Krecke, G.A. Worrell, J.D. Bartleson, D.H. Lachance. Stroke-Like Migraine Attacks after Radiation Therapy (SMART) Syndrome Is Not Always Completely Reversible: A Case Series. (2013) American Journal of Neuroradiology. 34 (12): 2298. doi:10.3174/ajnr.A3602 - Pubmed
- 2. Joost P. Kerklaan, Geert J. Lycklama á Nijeholt, Ruud G. J. Wiggenraad, Bianca Berghuis, Tjeerd J. Postma, Martin J. B. Taphoorn. SMART syndrome: a late reversible complication after radiation therapy for brain tumours. (2011) Journal of Neurology. 258 (6): 1098. doi:10.1007/s00415-010-5892-x