Teaching NeuroImages: Radiation-associated symptomatic carotid artery disease with ipsilateral radiodermatitis

A 68-year-old man with a history of squamous cell carcinoma of the tongue treated with external beam radiation therapy in 2007 presented in 2013 with acute onset expressive aphasia and right lower facial weakness. MRI confirmed an acute infarct in the left frontal cortex. CT angiography revealed occlusion vs critical stenosis of the left internal carotid artery, new from 2007. Examination of the patient's neck revealed ipsilateral radiodermatitis (figure). Therapeutic neck irradiation has been associated with accelerated atheromatous disease, carotid artery stenosis, and increased risk of stroke.1,2 Ipsilateral radiodermatitis may be a sign of underlying carotid artery stenosis.

Source: Neurology - February 2, 2015 Category: Neurology Authors: Ehrlich, M. E., Gulvezan, T., Southerland, A. M. Tags: All Imaging, All Cerebrovascular disease/Stroke RESIDENT AND FELLOW SECTION Source Type: research