TY - JOUR
T1 - Susceptibility-weighted imaging in stroke-like migraine attacks after radiation therapy syndrome
AU - Khanipour Roshan, Sara
AU - Salmela, Michael B.
AU - McKinney, Alexander M.
PY - 2015/8/5
Y1 - 2015/8/5
N2 - Introduction: Stroke-like migraine attacks after radiation therapy (SMART) syndrome has a characteristic clinical presentation and postcontrast T1WI MRI appearance. Susceptibility-weighted imaging (SWI) may help distinguish SMART from other disorders that may have a similar postcontrast MRI appearance. Methods: The MRI examinations of four patients with SMART syndrome are described herein, each of which included SWI, FLAIR, DWI, and postcontrast T1WI on the presenting and follow-up MRI examinations. Results: In each, the initial SWI MRI demonstrated numerous susceptibility hypointensities <5 mm in size throughout the cerebrum, particularly within the periventricular white matter (PVWM), presumably related to radiation-induced cavernous hemangiomas (RICHs). By follow-up MRI, each postcontrast examination had demonstrated resolution of the gyriform enhancement on T1WI, without susceptibility hypointensities on SWI within those previously enhancing regions. Conclusion: These preliminary findings suggest that SWI may help identify SMART syndrome or at least help discriminate it from other disorders, by the findings of numerous susceptibility hypointensities on SWI likely representing RICHs, gyriform enhancement on T1WI, and postsurgical findings or appropriate clinical history.
AB - Introduction: Stroke-like migraine attacks after radiation therapy (SMART) syndrome has a characteristic clinical presentation and postcontrast T1WI MRI appearance. Susceptibility-weighted imaging (SWI) may help distinguish SMART from other disorders that may have a similar postcontrast MRI appearance. Methods: The MRI examinations of four patients with SMART syndrome are described herein, each of which included SWI, FLAIR, DWI, and postcontrast T1WI on the presenting and follow-up MRI examinations. Results: In each, the initial SWI MRI demonstrated numerous susceptibility hypointensities <5 mm in size throughout the cerebrum, particularly within the periventricular white matter (PVWM), presumably related to radiation-induced cavernous hemangiomas (RICHs). By follow-up MRI, each postcontrast examination had demonstrated resolution of the gyriform enhancement on T1WI, without susceptibility hypointensities on SWI within those previously enhancing regions. Conclusion: These preliminary findings suggest that SWI may help identify SMART syndrome or at least help discriminate it from other disorders, by the findings of numerous susceptibility hypointensities on SWI likely representing RICHs, gyriform enhancement on T1WI, and postsurgical findings or appropriate clinical history.
KW - Radiation-induced cavernous hemangiomas
KW - SMART syndrome
KW - Stroke-like migraine attacks after radiation therapy
KW - Susceptibility-weighted imaging
UR - http://www.scopus.com/inward/record.url?scp=84946487727&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84946487727&partnerID=8YFLogxK
U2 - 10.1007/s00234-015-1567-8
DO - 10.1007/s00234-015-1567-8
M3 - Article
C2 - 26242361
AN - SCOPUS:84946487727
SN - 0028-3940
VL - 57
SP - 1103
EP - 1109
JO - Neuroradiology
JF - Neuroradiology
IS - 11
ER -