Rinsho Shinkeigaku (Clinical Neurology)

Case Report

Small vessel disease associated with cranial irradiation

Masatomo Miura, M.D.1)3), Makoto Nakajima, M.D. Ph.D.1), Akiko Fujimoto, M.D.1), Akihiko Ueda, M.D. Ph.D.1), Masaki Watanabe, M.D. Ph.D.1)2) and Yukio Ando, M.D. Ph.D.1)

1)Department of Neurology, Graduate School of Medical Sciences, Kumamoto University
2)Department of Advanced Medicine in Cerebral Vascular Disease, Kumamoto University
3)Department of Cerebrovascular Disease and Acute Coronary Syndrome, Kumamoto University

We report two cases of young patients with lacunar stroke who demonstrated multiple microbleeds (MBs) a long period after cranial irradiation. Case 1: a 44-year-old man developed dysarthria and left hemiparesis from a day before admission. Magnetic resonance imaging showed an acute lacunar infract in the right corona radiata. Case 2: a 28-year-old woman was admitted due to dysarthria and right hemiparesis. An acute lacunar infract was detected in the left corona radiata. T2* WI revealed multiple MBs in the region corresponding to the irradiation in both patients. Since these patients had no vascular risk factors except for smoking habit in the former one and dyslipidemia in the latter one. We speculated that lacunar stroke and MBs had resulted from past cranial irradiation. In addition to accelerated atherosclerosis of the large vessels, small vessel disease should be noted as an important long-term complication after cranial irradiation.
Full Text of this Article in Japanese PDF (689K)

(CLINICA NEUROL, 55: 743|747, 2015)
key words: small vessel disease, cranial irradiation, microbleeds, lacunar infract

(Received: 2-Apr-15)