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Recurrent stroke in childhood cancer survivors
Conclusion: Survivors of childhood cancer, particularly those previously treated with high-dose cranial radiation, have a high risk of recurrent stroke for decades after a first stroke. Although these strokes are mostly occurring in young adulthood, hypertension, an established atherosclerotic risk factor, independently predicts recurrent stroke in this population.
Source: Neurology - September 21, 2015 Category: Neurology Authors: Fullerton, H. J., Stratton, K., Mueller, S., Leisenring, W. W., Armstrong, G. T., Weathers, R. E., Stovall, M., Sklar, C. A., Goldsby, R. E., Robison, L. L., Krull, K. R. Tags: Childhood stroke, Stroke in young adults, All Cerebrovascular disease/Stroke, Primary brain tumor ARTICLE Source Type: research

Cerebral perfusion in stroke-like migraine attacks after radiation therapy syndrome
We present 2 patients with recurrent attacks of SMART syndrome with increased cerebral blood volume in affected regions and abnormal vascular reactivity on transcranial Doppler ultrasound, suggesting a potential mechanism.
Source: Neurology - February 22, 2016 Category: Neurology Authors: Olsen, A. L., Miller, J. J., Bhattacharyya, S., Voinescu, P. E., Klein, J. P. Tags: MRI, All Clinical Neurology, All Cerebrovascular disease/Stroke, Radiation therapy-tumor CLINICAL/SCIENTIFIC NOTES Source Type: research

Stroke in Children With Cancer: The Tip of the Iceberg?
We read with great interest the article by Noje et al. in which they analyzed the incidence and characteristics of stroke in children with cancer. Among a population of 1411 children with cancer, during a 10-year period registry, 15 children had stroke, corresponding to an overall prevalence of 1%. A slightly increased prevalence of stroke in children with brain tumors was documented (1.3%). The occurrence of stroke in children with brain tumors is potentiated by cranial radiation therapy. We are currently following a cohort of 103 adult survivors of childhood primary central nervous system tumors in our neurooncology c...
Source: Pediatric Neurology - December 6, 2013 Category: Neurology Authors: João Passos, Hipólito Nzwalo, Joana Marques, Ana Azevedo, Sofia Nunes, Duarte Salgado Tags: Letters to the Editor 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

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

Unusual case of recurrent SMART (stroke-like migraine attacks after radiation therapy) syndrome
Ramnath Santosh Ramanathan, Gayathri Sreedher, Konark Malhotra, Zain Guduru, Deeksha Agarwal, Mary Flaherty, Timothy Leichliter, Sandeep RanaAnnals of Indian Academy of Neurology 2016 19(3):399-401Stroke-like migraine attacks after radiation therapy (SMART) syndrome is a rare delayed complication of cerebral radiation therapy. A 53-year-old female initially presented with headache, confusion and left homonymous hemianopia. Her medical history was notable for cerebellar hemangioblastoma, which was treated with radiation in 1987. Her initial brain MRI (magnetic resonance imaging) revealed cortical enhancement in the right te...
Source: Annals of Indian Academy of Neurology - July 24, 2016 Category: Neurology Authors: Ramnath Santosh Ramanathan Gayathri Sreedher Konark Malhotra Zain Guduru Deeksha Agarwal Mary Flaherty Timothy Leichliter Sandeep Rana Source Type: research

Stroke like migraine attacks after radiation therapy (SMART) syndrome a case series of three patients (P6.179)
Conclusions:Our patients represent the first case series of SMART syndrome in a single institution. Our cases share similarities to the prior reports in the literature and highlights the clinical and MRI triad of acute onset headaches, neurological deficits and MRI findings of transient contrast enhancement of the cortex with white matter sparing in a previous radiation field.Disclosure: Dr. rauf has nothing to disclose. Dr. Boulter has nothing to disclose. Dr. Imitola has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Rauf, Y., Boulter, D., Imitola, J. Tags: Neurologic Complications of Cancer Source Type: research

Cancer and Cerebrovascular Disease
AbstractPurpose of ReviewTo review the latest information about the interactions between cancer and cerebrovascular disease.Recent FindingsAdditional data support the finding that both ischemic and hemorrhagic stroke are important complications of cancer or its treatment. Reperfusion therapy is being given successfully to patients with stroke complicating cancer.SummaryHemorrhagic stroke may occur with metastatic disease to the brain, coagulopathies from cancer, in particular leukemia, or as complications of chemotherapy. Ischemic stroke also may be a complication of metastatic disease with local invasion of vessels, a pro...
Source: Current Neurology and Neuroscience Reports - August 22, 2019 Category: Neuroscience Source Type: research

Status Epilepticus in Patients with SMART (P5.012)
CONCLUSIONS We describe three patients with SMART presenting with SE. Our cases raise the concern that SMART is not necessarily a migraine phenomenon but can be a form of focal SE associated with stroke-like symptoms. In patients with radiographic suspicion of SMART we suggest a low threshold for vEEG monitoring and aggressive anti-epileptic management.Disclosure: Dr. Fan has nothing to disclose. Dr. Gabriel has nothing to disclose. Dr. Gerard has nothing to disclose. Dr. Schuele has received personal compensation for activities with Sunovion and Eisai as a speaker.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Fan, P., Gabriel, H., Gerard, E., Schuele, S. Tags: Neuromuscular Disease and Epilepsy ePoster Session Source Type: research

Comprehensive Update and Review of Clinical and Imaging Features of SMART Syndrome ADULT BRAIN
SUMMARY: Stroke-like migraine attacks after radiation therapy (SMART) syndrome is a delayed complication of cranial irradiation, with subacute onset of stroke-like symptoms including seizures, visual disturbance, speech impairment, unilateral hemianopsia, facial droop, and aphasia, often associated with migraine-type headache. The diagnostic criteria were initially proposed in 2006. However, the diagnosis of SMART syndrome is challenging because clinical symptoms and imaging features of SMART syndrome are indeterminate and overlap with tumor recurrence and other neurologic diseases, which may result in inappropriate clinic...
Source: American Journal of Neuroradiology - June 8, 2023 Category: Radiology Authors: Ota, Y., Liao, E., Shah, G., Srinivasan, A., Capizzano, A. A. Tags: ADULT BRAIN Source Type: research

Headaches in brain tumor patients: primary or secondary?
CONCLUSION: Our literature review revealed that brain tumor headache uncommonly presents with classic brain tumor headache characteristics and often satisfies criteria for a primary headache category such as migraine or tension-type. Thus, clinicians may miss headaches due to brain tumors in following ICHD-3 criteria, and the distinction between primary and secondary headache disorders may not be so clear-cut. PMID: 24697234 [PubMed - in process]
Source: Headache - April 1, 2014 Category: Neurology Authors: Nelson S, Taylor LP Tags: Headache Source Type: research

Rt-08 * proton therapy (pt) large-volume re-irradiation for recurrent glioma: overall survival (os) and toxicity outcomes
CONCLUSION: Large-volume PT re-irradiation for recurrent glioma is safe and associated with promising OS outcomes, particularly in the setting of bevacizumab-refractory tumors.
Source: Neuro-Oncology - November 3, 2014 Category: Cancer & Oncology Authors: Desai, B., Rockne, R., Rademaker, A., Raizer, J., Paleologos, N., Merrell, R., Grimm, S., Azeem, S., Hartsell, W., Sweeney, P., Swanson, K., Gondi, V. Tags: RADIATION THERAPY (CLINICAL AND/OR LABORATORY RESEARCH) Source Type: research

Updates in outcomes of stereotactic radiation therapy in acromegaly
Conclusion Although the use of radiotherapy in patients with acromegaly has decreased with advances in medical treatments, it remains an effective treatment option after unsuccessful surgery and/or resistance or unavailability of medical therapy. Long-term studies evaluating secondary morbidity and mortality rate after the new stereotactic techniques are needed, in order to evaluate their potential brain-sparing effect.
Source: Pituitary - February 15, 2017 Category: Endocrinology Source Type: research

Study unveils a blueprint for treating a deadly brain tumor
(NIH/National Institute of Neurological Disorders and Stroke) In a study of mice and human brain tumors researchers at the University of the Michigan, Ann Arbor, searched for new treatments by exploring the reasons why some patients with gliomas live remarkably longer than others. The results suggested that certain patients' tumor cells are less aggressive and much better at repairing DNA than others but are difficult to kill with radiation. The researchers then showed that combining radiation therapy with cancer drugs designed to block DNA repair may be an effective treatment strategy.
Source: EurekAlert! - Cancer - February 19, 2019 Category: Cancer & Oncology Source Type: news

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