Stroke-Like Migraine Attacks After Radiation Therapy (SMART) Syndrome: A Case Report

Stroke-like migraine attacks after radiation therapy (SMART) syndrome is a rare and delayed complication of brain irradiation involving impaired cerebrovascular autoregulation, and diagnosis is based on distinct clinic-radiographic findings and exclusion of differentials. We report a 38-year-old man...

Full description

Saved in:
Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2024-07, Vol.16 (7), p.e63599
Main Authors: Valappil, Ashraf V, Ahammed Pk, Danish, Karunanidhi, Sellam, Sp, Harish Babu, Janardhanan, Sujith
Format: Article
Language:English
Subjects:
Age
Anticonvulsants
Aphasia
Autoimmune diseases
Blood
Brain cancer
Case reports
Creutzfeldt-Jakob disease
Edema
Encephalitis
Headaches
Migraine
Necrosis
Neurology
Oncology
Patients
Radiation therapy
Radiology
Steroids
Stroke
Tumors
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Stroke-like migraine attacks after radiation therapy (SMART) syndrome is a rare and delayed complication of brain irradiation involving impaired cerebrovascular autoregulation, and diagnosis is based on distinct clinic-radiographic findings and exclusion of differentials. We report a 38-year-old man, who received cranial irradiation 28 years before and developed episodes of headache and visual aura, followed by left hemianopia, aphasia, behavioral disturbances, and focal seizures. An MRI of the brain revealed gyral swelling with restricted diffusion and mild contrast enhancement over the right temporoparietal and occipital region, and fludeoxyglucose-FDG PET scan showed hyperperfusion in the corresponding brain region. He improved completely with pulse steroids and antiseizure medications. The recognition of this syndrome is important as we can reassure patients and their families and help avoid unnecessary and invasive diagnostic tests.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.63599