Radiation-induced spinal nerve root cavernous malformations as a rare cause of radiculopathy
A 48-year-old man with Hodgkin lymphoma presented with insidious painless asymmetric ankle then thigh weakness 16 years after mantle-field radiation. EMG was consistent with a motor lumbosacral polyradiculopathy. CSF had 15 white blood cells/μL, protein 387 mg/dL, and normal glucose. Nodular enhancing lesions were seen on lumbar MRI (figure 1). Caudal root biopsy demonstrated mulberry-shaped vascular abnormalities (figure 2) and thickened endoneurial vessel walls without inflammation. Workup for leptomeningeal carcinomatosis and inflammatory and infectious disease was negative. High-dose steroids produced no clinical improvement. A diagnosis of radiation-induced cavernous malformations, a rare complication of radiation previously reported in the cauda equina, was made.1,2
Source: Neurology - Category: Neurology Authors: Rastogi, K., Klein, C. J., O'Toole, J. E., Jhaveri, M. D., Malik, R. Tags: MRI, All Clinical Neurology, All Neuromuscular Disease, All Oncology, All Spinal Cord NEUROIMAGES Source Type: research
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