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We report on four patients with reversible clinical and radiological features occurring years after radiation for brain tumours, suggestive for the so called SMART syndrome (stroke-like migraine attacks after radiation therapy). All four patients (males, age 36-60 years) had been treated with focal brain radiation for a primary brain tumour or with whole-brain radiation therapy for brain metastases. Ranging from 2 to 10 years following radiation therapy patients presented with headache and focal neurological deficits, suggestive for tumour recurrence. Two patients also presented with focal seizures. MRI demonstrated typical cortical swelling and contrast enhancement, primarily in the parieto-occipital region. On follow-up both clinical and MRI features improved spontaneously. Three patients eventually proved to have tumour recurrence. |
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complications gyrus,abnormal headache migraine MRI,abnormal MRI,cortical enhancement MRI,disappearing lesion on MRI,gyral enhancement MRI,gyral swelling neoplasm,primary intracerebral neoplasm,primary of CNS-treatment of neurologic examination,focal radiation therapy,CNS treatment and complications with seizure SMART syndrome strokelike episodes
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