A 15-year-old girl with acute and reversible neurologic symptoms after cranial irradiation for medulloblastoma

A 15-year-old girl with history of medulloblastoma was evaluated for headache and acute onset neurologic deficits 5 years after completion of initial radiation therapy and 3 years following completion of re-irradiation. Neurological examination was notable for new onset left hemianopia, hemiparesis and neglect. MRI showed extensive areas of cortical T2 prolongation and thickening involving the right parietal, occipital and temporal lobes, with associated extensive gyral enhancement. Upon spontaneous resolution of her weakness after 4 days, repeat MRI showed resolution of the edema and gyral enhancement, suggestive of the diagnosis of stroke-like migraine attacks after radiation therapy (SMART syndrome).
Source: Seminars in Pediatric Neurology - Category: Neurology Authors: Source Type: research