Division of Neurology, Stanford University, Palo Alto, CA, USA.
Semin Pediatr Neurol. 2012 Mar;19(1):18-24. doi: 10.1016/j.spen.2012.02.012.
The outcomes for childhood cancer have drastically improved over the last several decades. Previously, irradiation was commonly used for blood-borne (leukemia, lymphoma) cancers and neck and brain tumors. Radiation therapy remains the mainstay of treatment for highly malignant cancers of head and neck and for some primary central nervous system tumors. Unfortunately, radiation therapy has been implicated as a contributor to many late effects of treatment, including cerebrovascular disease from large-vessel vascular injury, stroke, moyamoya, mineralizing microangiopathy, to stroke-like migraine. This review summarizes the pathophysiology of these disorders in relationship to treatment with and without radiation as well as the relevant manifestations of radiation-induced cerebrovascular disease. Patient populations at highest risk and current recommendations for health providers and patient education are emphasized when possible.
过去几十年中，儿童癌症的治疗效果有了显著的提高。以前，辐射治疗常用于血液癌（白血病、淋巴瘤）和颈部及脑部肿瘤。放射疗法仍然是治疗高度恶性的头颈部癌症和某些原发性中枢神经系统肿瘤的主要手段。不幸的是，辐射疗法被认为是治疗后许多晚期并发症的原因之一，包括大血管损伤引起的脑血管疾病、中风、烟雾病、矿化性微血管病和类似中风的偏头痛。本综述总结了这些疾病与放疗和无放疗治疗的关系以及辐射引起的脑血管疾病的相关表现的病理生理学。当可能时，强调了高危患者人群以及为医疗保健提供者和患者提供教育的建议。
