Mechanisms of post-radiation injury: cerebral microinfarction not a significant factor

Post-radiation leukoencephalopathy is characterized by cognitive impairment and white matter alternations on imaging. Cerebral small vessel disease (SVD) is one of several suggested etiologies. Cerebral microinfarction (CMI) is a recently described marker of SVD. We sought to examine the rate of CMI...

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Bibliographic Details
Published in:Journal of neuro-oncology 2017, Vol.131 (2), p.277-281
Main Authors: Molad, J. A., Blumenthal, D. T., Bokstein, F., Findler, M., Finkel, I., Bornstein, N. M., Yust-Katz, S., Auriel, E.
Format: Article
Language:English
Subjects:
Brain Neoplasms - complications
Brain Neoplasms - diagnostic imaging
Brain Neoplasms - radiotherapy
Cerebral Infarction - complications
Cerebral Infarction - diagnostic imaging
Cerebral Small Vessel Diseases - complications
Cerebral Small Vessel Diseases - diagnostic imaging
Clinical Study
Diffusion Magnetic Resonance Imaging
Female
Humans
Leukoencephalopathies - diagnostic imaging
Leukoencephalopathies - etiology
Male
Medicine
Medicine & Public Health
Middle Aged
Neurology
Oncology
Radiation Injuries - complications
Radiation Injuries - diagnostic imaging
Radiotherapy - adverse effects
Retrospective Studies
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Summary:Post-radiation leukoencephalopathy is characterized by cognitive impairment and white matter alternations on imaging. Cerebral small vessel disease (SVD) is one of several suggested etiologies. Cerebral microinfarction (CMI) is a recently described marker of SVD. We sought to examine the rate of CMI as a biomarker of ongoing ischemia among patients who underwent brain radiotherapy (RT). 110 patients treated with RT for primary or metastatic brain tumors were enrolled. A total of 685 brain MRI tests performed 1–108 months post-radiation were examined. The annual incidence of CMI was calculated. Only 2 definite CMI were found (2/685, 0.3 %). The calculated annual incidence of CMI was 0.11. This incidence is similar to the normal population, and lower than the reported incidence in patients with intracerebral hemorrhage or cognitive impairment. CMI incidence in patients treated with brain RT is similar to the general population. This finding suggests that post-radiation leukoencephalopathy and cognitive impairment are not due to active SVD solely but rather secondary to other causes such as inflammation, metabolic or direct cell damage.
ISSN:0167-594X
1573-7373
DOI:10.1007/s11060-016-2291-x