Clin Nucl Med. 2010 Aug;35(8):583-5.

Normal cerebrovascular reactivity in Stroke-like Migraine Attacks after Radiation Therapy syndrome.

Farid K, Meissner WG, Samier-Foubert A, Barret O, Menegon P, Rouanet F, Fernandez P, Orgogozo JM, Allard M, Tison F, Sibon I.

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CHU de Bordeaux, Service de Médecine Nucléaire, Bordeaux, France. kwfarid@hotmail.com

Abstract

Stroke-like Migraine Attacks after Radiation Therapy (SMART) syndrome is a rare complication of cranial irradiation. Radiation is well-known to impair vascular vessel architecture and function. We investigated the hypothesis of radiation-induced cerebral vascular reserve dysfunction as the underlying mechanism of SMART. Interictal cerebrovascular reactivity was investigated using Tc-99m hexamethylpropyleneamine oxime-SPECT and acetazolamide challenge in 3 patients. We found interictal hypoperfusion and normal cerebrovascular reactivity in all patients. Neither ictal restriction of the apparent diffusion coefficient nor MR angiography abnormalities were observed. These findings do not support a vascular mechanism in SMART syndrome. Postradiation neuronal dysfunction may be the underlying mechanism. Further investigations on larger series are needed to confirm this hypothesis.

PMID:: 20631504; [PubMed - indexed for MEDLINE]

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Normal cerebrovascular reactivity in Stroke-like Migraine Attacks after Radiation Therapy syndrome.

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