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Total 256 results found since Jan 2013.

Risk of Stroke After Definitive Radiotherapy —Cause for Concern or Modest Risk?
With the rapidly increasing prevalence of oropharyngeal squamous cell carcinoma (OPSCC), largely driven by the human papillomavirus (HPV) epidemic, and with relative equipoise between radiation-based and surgery-based treatment protocols, there has been renewed interest in describing differences in functional outcomes between the 2 treatment modalities. Radiation is theoretically related to stroke risk due to carotid artery intimal injury, which could lead to the development of atherosclerosis. Both carotid artery stenosis and carotid intima-medial thickness have been shown to be associated with radiation therapy providing...
Source: JAMA Otolaryngology - Head and Neck Surgery - June 23, 2022 Category: ENT & OMF Source Type: research

Evaluating the Primary Prevention of Ischemic Stroke of Oral Antithrombotic Therapy in Head and Neck Cancer Patients with Radiation Therapy.
Abstract Although previous studies demonstrated the risk of ischemic stroke (IS) in patients with head and neck cancer (HNC), the impact of oral antithrombotic therapy (OAT) on this risk has not yet been assessed. We aimed to evaluate the effectiveness and safety of OAT in patients with HNC treated with RT. This retrospective cohort study was performed using the National Health Insurance Research Database of Taiwan. A total of 37,638 patients diagnosed with HNC included in the study were classified as users and nonusers of OAT. Primary outcome was IS or transient ischemic attack (TIA), and secondary outcomes were ...
Source: Biomed Res - December 20, 2016 Category: Research Authors: Hsu CW, Huang YB, Kuo CC, Chen CY Tags: Biomed Res Int Source Type: research

A Great Heist: Subclavian Steal Syndrome Causing Posterior Transient Ischemic Attack and Stroke
Conclusion This case illustrates a case of vertebrobasilar transient ischemic attack and posterior circulation stroke from subclavian steal syndrome in the setting of prior radiation therapy manifesting as extremity weakness and discoordination. Further research on therapeutic radiation dosages and subsequent incidence of arterial disease which could contribute to subclavian steal syndrome is necessary.PMID:36036849 | DOI:10.7812/TPP/21.234
Source: The Permanente journal - August 29, 2022 Category: General Medicine Authors: Jonathan D Woo Joshua E Markowitz Source Type: research

SMART Syndrome (Stroke-Like Migraine Attacks after Radiation Therapy) in Adult and Pediatric Patients (P03.007)
CONCLUSIONS: SMART syndrome appears to be a reversible and recurrent long term complication of cranial irradiation. A review of the data indicates that age and gender may play a role in the development of the disease. Additionally, we postulate other mechanisms of SMART syndrome including possible genetic and hormonal influences.Disclosure: Dr. Armstrong has nothing to disclose. Dr. DiMario has received personal compensation for activities with E-Pocrates.
Source: Neurology - February 14, 2013 Category: Neurology Authors: Armstrong, A., DiMario, F. Tags: P03 Child Neurology II Source Type: research

Stroke-Like Migraine Attacks after Radiation Therapy (SMART) Syndrome Is Not Always Completely Reversible: A Case Series FELLOWS' JOURNAL CLUB
SUMMARY: We retrospectively reviewed clinical and imaging findings in 11 patients with stroke-like migraine attacks after radiation therapy (SMART) syndrome to better understand this disorder previously thought to be reversible. Six men and 5 women had complex bouts of neurologic impairment beginning, on average, 20 years after cerebral irradiation. All had characteristic, unilateral gyriform enhancement on MR imaging that developed within 2–7 days and typically resolved in 2–5 weeks. Unlike prior reports, 45% had incomplete neurologic recovery manifesting as dysphasia, cognitive impairment, or hemiparesis. The...
Source: American Journal of Neuroradiology - December 13, 2013 Category: Radiology Authors: Black, D. F., Morris, J. M., Lindell, E. P., Krecke, K. N., Worrell, G. A., Bartleson, J. D., Lachance, D. H. Tags: FELLOWS ' JOURNAL CLUB Source Type: research

Risk of Symptomatic Stroke After Radiation Therapy for Childhood Cancer: A Long-Term Follow-Up Cohort Analysis
Long-term childhood cancer survivors are at high risk of late adverse effects, including stroke. We aimed to determine the cumulative incidence of clinically validated symptomatic stroke (transient ischemic attack [TIA], cerebral infarction, and intracerebral hemorrhage [ICH]) and to quantify dose-effect relationships for cranial radiation therapy (CRT) and supradiaphragmatic radiation therapy (SDRT).
Source: International Journal of Radiation Oncology * Biology * Physics - April 6, 2016 Category: Radiology Authors: Irma W.E.M. van Dijk, Helena J.H. van der Pal, Rob M. van Os, Yvo B.W.E.M. Roos, Elske Sieswerda, Elvira C. van Dalen, Cécile M. Ronckers, Foppe Oldenburger, Flora E. van Leeuwen, Huib N. Caron, Caro C.E. Koning, Leontien C.M. Kremer Tags: Clinical Investigation Source Type: research

Ntox-11. recurrent episodes of stroke-like migraine attacks after radiation therapy (smart) syndrome in adults
We report two cases of multiply-recurrent SMART syndrome, one autopsy-documented. Case 1 is a 46 year old woman with an atypical meningioma treated with resection and radiation who presented sixteen months after completion of radiation with sudden onset hemiparesis and dysarthria. Brain MRI showed the typical gyriform enhancement seen in SMART syndrome. No other attributable disorders were found on extensive workup, and both symptoms and radiographic abnormalities resolved over several weeks without further therapies. Six months later she again presented with identical symptoms and MRI findings. Incomplete resolution ...
Source: Neuro-Oncology - November 6, 2016 Category: Cancer & Oncology Authors: Mohler, A., Kleinschmidt-DeMasters, B. K., Damek, D. Tags: NEUROTOXICITY OF THERAPY Source Type: research

Pathologic Findings of Symptomatic Carotid Artery Stenosis Several Decades after Radiation Therapy: A Case Report
Improved long-term survival of malignancy has drawn increased attention to late cerebrovascular toxicity after neck radiotherapy. Recently, neck radiotherapy has been found as a significant risk factor of carotid artery stenosis and ischemic stroke; however, long-term adverse effects of radiation in large arteries remain unknown. Here, we described an autopsied case with recurrent ischemic stroke associated with ipsilateral carotid artery stenosis several decades after neck radiation therapy. Pathologically, there were intima-media fibrosis, endothelial cell loss, and decreased expression of thrombomodulin in irradiated ca...
Source: Journal of Stroke and Cerebrovascular Diseases - January 11, 2018 Category: Neurology Authors: Shuichi Tonomura, Keiji Shimada, Naoko Funatsu, Yoshiaki Kakehi, Hisao Shimizu, Nobuyuki Takahashi Tags: Case Studies Source Type: research

A Case of Stroke-like Migraine Attacks after Radiation Therapy (SMART) Syndrome Followed by Cerebral Infarction.
Authors: Takahashi H, Kimura T, Yuki N, Yoshioka A Abstract A 36-year-old man with a history of irradiation for acute lymphoblastic leukemia developed headache with cortical dysfunction lasting for 4 weeks. The clinical features were consistent with stroke-like migraine attacks after radiation therapy (SMART) syndrome. Six months later, he developed cerebral infarction due to occlusions of the left anterior and middle cerebral arteries. This is the first case report describing SMART syndrome followed by severe cerebral infarction. Although an association between the two episodes was not assumed, this case indicates...
Source: Internal Medicine - March 3, 2018 Category: Internal Medicine Tags: Intern Med Source Type: research

Stroke-like migraine attacks after radiation therapy (SMART) syndrome —a case series and review
ConclusionOur extensive review favors MRI, CT, and prolonged EEG monitoring to rule out other differentials and showed that initiation of corticosteroid therapy and antiepileptic treatment were helpful in the resolution of symptoms and prevent recurrences. Therefore, future studies should be focused on early identification and management guidelines for SMART syndrome.
Source: Neurological Sciences - July 12, 2020 Category: Neurology Source Type: research

Lacunar stroke as a very late complication of radiotherapy: value of nuclear medicine techniques.
CONCLUSIONS: The reappearance of neurological symptoms years after radiotherapy of a brain neoplasm poses a diagnostic dilemma. Current diagnostic techniques are very accurate but present false positives. The various nuclear medicine techniques, in particular PET-CT 11C-methionine, are a diagnostic aid. With the presentation of this case we intend to draw attention to one of the late complications of radiation therapy and the various differential diagnoses. Diagnostic and therapeutic advances have increased the life expectancy of cancer patients, so these late complications are expected to be more frequent. PMID: 3331...
Source: Revista de Neurologia - December 16, 2020 Category: Neurology Authors: Ortega-Valín F, Jiménez-Bonilla JF, García-Hernández A, Rodríguez-Rodriguez E, Sánchez-Salmón E Tags: Rev Neurol Source Type: research

SMART Syndrome (Stroke-like migraine attacks after radiation therapy): When to suspect it?
CONCLUSION: The triad of migraine, seizure, and hemiparesis within the context of a prior brain radiotherapy should promptly raise the suspicion of SMART syndrome. Prompt diagnosis is essential to avoid unnecessary invasive investigations.PMID:34877047 | PMC:PMC8645481 | DOI:10.25259/SNI_893_2021
Source: Surgical Neurology International - December 8, 2021 Category: Neurosurgery Authors: Petros Angelidis Christian Saleh Phillip Jaszczuk Muhannad Seyam Katarina Alexandra Ebner Margret Hund-Georgiadis Source Type: research