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Neurologic sequelae may occur months to years after cranial irradiation. The site of primary damage is probably the vascular endothelium.Over a 2. 8-year period,four children with brain tumors,a mean of 11 years of age at diagnosis(range,6.5 to 15.5 years),had new onset of severe intermittent unilateral headaches associated with nausea,episodic visual loss, hemiparesis,aphasia,or hemisensory loss.We conclude that(1)"complicated migraine-like episode"may occur in children after cranial irradiation and chemotherapy as a sequela of therapy;(2)these headaches may not be the harbinger of impeding strokes,severe intracranial vasculitis,or tumor recurrence;(3)while cerebral angiography may be useful in differential diagnosis,it may cause transient worsening of symptoms. |
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