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Stroke-Like Migraine Attacks after Radiation Therapy (SMART) Syndrome is not Always Completely Reversible: A Case Series
AJNR 34:2298-2303, Black, D.F.,et al, 2013
See this aricle in Pubmed

Article 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 dysphagia, 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.
 
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brain biopsy
complications
gyrus,abnormal
headache
laminar necrosis,cortical
migraine
MRI,disappearing lesion on
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MRI,serial
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radiation therapy,CNS treatment and complications with
seizure
seizure,pilomotor
SMART syndrome
strokelike episodes

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