Valappil Ashraf V, Ahammed Pk Danish, Karunanidhi Sellam, Sp Harish Babu, Janardhanan Sujith
Neurology, Aster Malabar Institute of Medical Sciences Ltd (MIMS) Hospital Calicut, Kozhikode, IND.
Nuclear Medicine, Aster Malabar Institute of Medical Sciences Ltd (MIMS) Hospital Calicut, Kozhikode, IND.
Cureus. 2024 Jul 1;16(7):e63599. doi: 10.7759/cureus.63599. eCollection 2024 Jul.
Stroke-like migraine attacks after radiation therapy (SMART) syndrome is a rare and delayed complication of brain irradiation involving impaired cerebrovascular autoregulation, and diagnosis is based on distinct clinic-radiographic findings and exclusion of differentials. We report a 38-year-old man, who received cranial irradiation 28 years before and developed episodes of headache and visual aura, followed by left hemianopia, aphasia, behavioral disturbances, and focal seizures. An MRI of the brain revealed gyral swelling with restricted diffusion and mild contrast enhancement over the right temporoparietal and occipital region, and fludeoxyglucose-FDG PET scan showed hyperperfusion in the corresponding brain region. He improved completely with pulse steroids and antiseizure medications. The recognition of this syndrome is important as we can reassure patients and their families and help avoid unnecessary and invasive diagnostic tests.
放射治疗后类卒中样偏头痛发作（SMART）综合征是脑部放疗罕见的迟发性并发症，涉及脑血管自动调节功能受损，诊断基于独特的临床影像学表现及鉴别诊断的排除。我们报告一名38岁男性，他在28年前接受了颅脑照射，之后出现头痛和视觉先兆发作，随后出现左侧偏盲、失语、行为障碍和局灶性癫痫发作。脑部MRI显示右侧颞顶枕区脑回肿胀伴扩散受限及轻度强化，氟脱氧葡萄糖-FDG PET扫描显示相应脑区血流灌注增加。他通过脉冲类固醇和抗癫痫药物治疗后完全康复。认识到这种综合征很重要，因为我们可以让患者及其家属放心，并有助于避免不必要的侵入性诊断检查。
