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Fulminant Strokes Secondary to Radiation-induced Small-vessel Arteriopathy

Published online by Cambridge University Press:  02 May 2014

Charles D. Kassardjian ,
Ari Breiner  and
Martin del Campo
Charles D. Kassardjian*
Affiliation:
University of Toronto, Toronto, Ontario, Canada
Ari Breiner
Affiliation:
University of Toronto, Toronto, Ontario, Canada Toronto General Hospital, Toronto, Ontario, Canada
Martin del Campo
Affiliation:
University of Toronto, Toronto, Ontario, Canada Toronto Western Hospital, Toronto, Ontario, Canada Krembil Neurosciences Centre, Totonto, Ontario, Canada
*
Address for correspondence: Charles D. Kassardjian, MD, 399 Bathurst St, Suite WW5-443, Toronto, Ontario, M5T 2S8, Canada. E-mail: [email protected]
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Abstract

Delayed vasculopathy associated with prior brain irradiation is a known cause of stroke. Radiation is implicated in large-vessel stenosis, cavernous malformations and, rarely, small-vessel disease. There have been no reported cases of fulminant ischaemic and haemorrhagic strokes secondary to radiation vasculopathy. We present the case of a 40-year-old woman with a history of childhood leukaemia and whole-body and cranio-cervical radiation. The patient presented with recurrent acute neurological deficits over a 4-month period resulting from haemorrhagic and ischaemic strokes. Imaging revealed numerous cavernomas and small-vessel acute infarctions. No traditional stroke aetiology was identified. Delayed radiation-induced vasculopathy should be considered in patients with a history of brain irradiation and ischaemic or haemorrhagic strokes, and can present in a fulminant manner with recurrent strokes over a short period of time.

Keywords

cavernomaradiation-vasculopathylacunar infarcts
Type
Clinical Practice: Current Opinion
Information
Brain Impairment , Volume 15 , Issue 1 , May 2014 , pp. 58 - 60
Copyright
Copyright © Australasian Society for the Study of Brain Impairment 2014 

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References

Kang, J.H., Kwon, S.U., & Kim, J.S. (2002). Radiation-induced angiopathy in acute stroke patients. Journal of Stroke and Cerebrovascular Diseases, 11 (6), 315–319.Google Scholar
Keezer, M.R., & Del Maestro, R. (2009). Radiation-induced cavernous hemangiomas: case report and literature review. Canadian Journal of Neurological Sciences, 36 (3), 303–310.Google Scholar
Plummer, C., Henderson, R.D., O’Sullivan, J.D., & Read, S.J. (2011). Ischemic stroke and transient ischemic attack after head and neck radiotherapy: a review. Stroke, 42 (9), 2410–2418.Google Scholar
Salih, I.S., Higgins, N.J., Warburton, E.A., & Baron, J.C. (2007). Lacunar stroke attributable to radiation-induced intracranial arteriopathy. European Journal of Neurology, 14 (8), 937–939.Google Scholar
Shobha, N., Smith, E.E., Demchuk, A.M., & Weir, N.U. (2009). Small vessel infarcts and microbleeds associated with radiation exposure. Canadian Journal of Neurological Sciences, 36 (3), 376–378.CrossRefGoogle ScholarPubMed