Normal cerebrovascular reactivity in stroke-like migraine attacks after radiation therapy syndrome

Karim Farid, Wassilios G. Meissner, Alexandra Samier-Foubert, Olivier Barret, Patrice Menegon, François Rouanet, Philippe Fernandez, Jean Marc Orgogozo, Michèle Allard, François Tison, Igor Sibon
Clinical Nuclear Medicine. 2010-08-01; 35(8): 583-585
DOI: 10.1097/RLU.0b013e3181e4db6f

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1. Clin Nucl Med. 2010 Aug;35(8):583-5. doi: 10.1097/RLU.0b013e3181e4db6f.

Normal cerebrovascular reactivity in Stroke-like Migraine Attacks after Radiation
Therapy syndrome.

Farid K(1), Meissner WG, Samier-Foubert A, Barret O, Menegon P, Rouanet F,
Fernandez P, Orgogozo JM, Allard M, Tison F, Sibon I.

Author information:
(1)CHU de Bordeaux, Service de Médecine Nucléaire, Bordeaux, France.

Stroke-like Migraine Attacks after Radiation Therapy (SMART) syndrome is a rare
complication of cranial irradiation. Radiation is well-known to impair vascular
vessel architecture and function. We investigated the hypothesis of
radiation-induced cerebral vascular reserve dysfunction as the underlying
mechanism of SMART. Interictal cerebrovascular reactivity was investigated using
Tc-99m hexamethylpropyleneamine oxime-SPECT and acetazolamide challenge in 3
patients. We found interictal hypoperfusion and normal cerebrovascular reactivity
in all patients. Neither ictal restriction of the apparent diffusion coefficient
nor MR angiography abnormalities were observed. These findings do not support a
vascular mechanism in SMART syndrome. Postradiation neuronal dysfunction may be
the underlying mechanism. Further investigations on larger series are needed to
confirm this hypothesis.

DOI: 10.1097/RLU.0b013e3181e4db6f
PMID: 20631504 [Indexed for MEDLINE]

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