We present the MRI findings of delayed brain damage in a patient who underwent radiotherapy after resection of an oligo-astrocytoma. The lesions appeared years later within brain tissue that was included in radiation fields. High-field 3 Tesla MR investigation gave us the possibility to appreciate the different aspects of the vasculopathy induced by irradiation. A literature review allowed us to hypothesize the correlations between imaging and pathological findings.
BallWSPrengerEC: Neurotoxicity of radio/chemotherapy in children: Pathologic and MR evaluation. Am J Neuroradiol13: 761–776, 1992.
2.
BaumgartnerJEAterJL: Pathologically proven cavernous angiomas of the brain following radiation therapy for pediatric brain tumors. Pediatric Neurosurgery39: 201–207, 2003.
3.
De SantisFAgatiR: Pathogenesis of “De Novo” Cavernous Malformations. A Case Report and Review of the Literature. Rivista di Neuroradiologia14: 445–452, 2001.
4.
GaenslerEHLDillonWP: Radiation-induced telangectasia in the brain simulated cryptic vascular malformations at MR imaging. Radiology193: 629–636, 1994.
5.
HecklSAschoffA: Radiation-induced Cavernous Hemangiomas of the Brain. A Late Effect Predominantly in Children. Cancer94: 3285–3291, 2002.
6.
JellingerK: Human central nervous system lesions following radiation therapy. Zentralbl Neurochir38: 199–200, 1977.
7.
KoikeSAidaN: Asymptomatic radiation-induced Telangectasia in children after cranial irradiation: Frequency, latency, and dose relation. Radiology230: 93–99, 2004.
8.
LeeJKLChlevarajahR: Rare presentation of delayed Radiation injury: A lobar hematoma and a cystic space-occupying lesion appearing more than 15 years after cranial radiotherapy: Report of two cases. Neurosurgery54: 1010–1013, 2004.
9.
LorenzoNDNollettiA: Late cerebral radionecrosis. Surg. Neurol10: 281–290, 1978.
10.
MaederPGudinchetF: Development of a Cavernous Malformation of the Brain. Am J Neuroradiol19: 1141–1145, 1998.
11.
MarksJEBaglanRJ: Cerebral radionecrosis: Incidence and risk in relation to dose, time, fractionation and volume. Int. J Radiat. Oncol Biol Phys7: 243–252, 1981.
OkedaRShibataT: Radiation encephalopathy: An autopsy case and some comments on the pathogenesis of delayed radionecrosis of the central nervous system. Acta Pathol Jpn23: 867–883, 1973.
15.
PozzatiEGiangasperoF: Occult Cerebrovascular Malformations after Irradiation. Neurosurgery, 39: 677–684, 1996.
16.
PoussaintTYSiffertJ: Hemorrhagic Vasculopathy after Treatment of Central Nervous System Neoplasia in Childhood: Diagnosis and Follow-up. Am J Neuroradiol16: 693–699, 1995.
17.
RigamontiDJohnsonPC: Cavernous malformations and capillary telangectasia: A spectrum within a single pathological entity. Neurosurgery28: 60–64, 1991.
18.
ValkPEDillonWP: Radiation injury of the brain. Am J Neuroradiol12: 45–62, 1991.