Acute hemorrhage in late radiation necrosis of the temporal lobe : report of five cases and review of the literature

• Published in: Journal of neuro-oncology 2001, Vol.51 (2), p.143-150
• Main Authors: CHENG, Kin-Ming, CHAN, Chi-Ming, FU, Yiu-Tung, HO, Luen-Cheong, CHEUNG, Fung-Ching, LAW, Chun-Key
• Format: Article
• Language: English
• Subjects: Adult; Aged; Biological and medical sciences; Cerebral Hemorrhage - diagnostic imaging; Cerebral Hemorrhage - etiology; Cerebral Hemorrhage - surgery; Diseases of the upper aerodigestive tract; Ent and stomatology; Female; Humans; Male; Medical sciences; Middle Aged; Nasopharyngeal Neoplasms - radiotherapy; Necrosis; Radiation Injuries - complications; Radiation Injuries - etiology; Radiation Injuries - pathology; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Temporal Lobe - surgery; Tomography, X-Ray Computed; Tropical medicine
• ISSN: 0167-594X; 1573-7373
• DOI: 10.1023/A:1010631112015

Hemorrhage in late cerebral radiation necrosis is a rare complication after radiotherapy for intracranial and extracranial neoplasms. We report 5 cases of acute hemorrhage in late radiation necrosis of the temporal lobe following radiation therapy for nasopharyngeal carcinoma. In a review of the literature, the authors identified a total of 27 such cases. The interval period between the onset of hemorrhage and cranial irradiation is long (mean = 7.8 years). The most prominent histological feature was the proliferation of large, dilated and thin-walled new blood vessels in a background of gliosis and fibrinoid necrosis of vessels. Rupture of these thin-walled new blood vessels is the proposed mechanism of hemorrhage in this condition.