Title |
Stroke-Like Migraine Attacks after Radiation Therapy (SMART) Syndrome Is Not Always Completely Reversible: A Case Series
|
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Published in |
American Journal of Neuroradiology, June 2013
|
DOI | 10.3174/ajnr.a3602 |
Pubmed ID | |
Authors |
D.F. Black, J.M. Morris, E.P. Lindell, K.N. Krecke, G.A. Worrell, J.D. Bartleson, D.H. Lachance |
Abstract |
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 remaining 55% recovered completely over an average of 2 months. Three of 11 patients developed cortical laminar necrosis. Brain biopsies in 4 of 11 did not demonstrate a specific pathologic substrate. These additional 11 patients contribute to the understanding of variability in stroke-like migraine attacks after radiation therapy syndrome, which often but not uniformly manifests with headaches and seizures, demonstrates a typical evolution of imaging findings, and may result in permanent neurologic and imaging sequelae. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
Spain | 2 | 25% |
India | 1 | 13% |
United Kingdom | 1 | 13% |
United States | 1 | 13% |
Unknown | 3 | 38% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 7 | 88% |
Science communicators (journalists, bloggers, editors) | 1 | 13% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
United States | 4 | 3% |
Netherlands | 1 | <1% |
Switzerland | 1 | <1% |
Canada | 1 | <1% |
United Kingdom | 1 | <1% |
Unknown | 132 | 94% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Other | 22 | 16% |
Researcher | 22 | 16% |
Student > Ph. D. Student | 15 | 11% |
Student > Postgraduate | 14 | 10% |
Student > Master | 8 | 6% |
Other | 37 | 26% |
Unknown | 22 | 16% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 70 | 50% |
Neuroscience | 11 | 8% |
Nursing and Health Professions | 5 | 4% |
Psychology | 5 | 4% |
Agricultural and Biological Sciences | 3 | 2% |
Other | 10 | 7% |
Unknown | 36 | 26% |