This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Mitchell, W. G. Articles by Siegel, S. M. Search for Related Content PubMed PubMed Citation Articles by Mitchell, W. G. Articles by Siegel, S. M. Social Bookmarking                         What's this?

Stroke As a Late Sequela of Cranial Irradiation for Childhood Brain Tumors

Division of Neurology, Department of Radiology, Children's Hospital of Los Angeles, Departments of Neurology, Pediatrics, and Radiology, University of Southern California School of Medicine, Los Angeles, CA

Lawrence S. Fishman, MD

Division of Neurology, Department of Radiology, Children's Hospital of Los Angeles, Departments of Neurology, Pediatrics, and Radiology, University of Southern California School of Medicine, Los Angeles, CA

John H. Miller, MD

Division of Nuclear Radiology, Department of Radiology, Children's Hospital of Los Angeles, Departments of Neurology, Pediatrics, and Radiology, University of Southern California School of Medicine, Los Angeles, CA

Marvin Nelson, MD

Division of Neuroradiology, Department of Radiology, Children's Hospital of Los Angeles, Departments of Neurology, Pediatrics, and Radiology, University of Southern California School of Medicine, Los Angeles, CA

Paul M. Zeltzer, MD

Division of Hematology-Oncology, Department of Pediatrics, Departments of Neurology, Pediatrics, and Radiology, University of Southern California School of Medicine, Los Angeles, CA

Daljit Soni, MD

Division of Radiation Oncology, Department of Radiology, Children's Hospital of Los Angeles, Departments of Neurology, Pediatrics, and Radiology, University of Southern California School of Medicine, Los Angeles, CA

Stuart M. Siegel, MD

Division of Hematology-Oncology, Department of Radiology, Children's Hospital of Los Angeles, Departments of Neurology, Pediatrics, and Radiology, University of Southern California School of Medicine, Los Angeles, CA

Cerebrovascular disease involving large and medium-size vessels is thought to be an uncommon sequela of treatment of childhood brain tumors. We reviewed 11 children who developed cerebrovascular disease manifested by strokes or transient ischemic attacks 6 months to 4 years after treatment of brain tumors, while their tumors were in remission. All had received radiation therapy, and seven had received chemotherapy. One child died of acute bilateral cerebral infarctions due to carotid occlusion on one side and marked stenosis on the other 2 years after receiving radiation therapy for an incompletely resected craniopharyngioma. Pathologically, there was marked subendothelial fibrosis of the vessels of the circle of Willis, with inflammatory changes surrounding some of the vessels.

In addition to the widely recognized small-vessel damage caused by radiation and chemotherapy in children (mineralizing microangiopathy), damage to medium and large intracranial vessels may result in late sequelae, manifested by stroke or transient ischemic attacks. (J Child Neurol 1991;6:128-133).

Journal of Child Neurology, Vol. 6, No. 2, 128-133 (1991)
DOI: 10.1177/088307389100600206


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				L. C. Jordan and P. K. Duffner Early-onset stroke and cerebrovascular disease in adult survivors of childhood cancer Neurology, December 1, 2009; 73(22): 1816 - 1817. [Full Text] [PDF]

				N. J. Ullrich, R. Robertson, D. D. Kinnamon, R. M. Scott, M. W. Kieran, C. D. Turner, S. N. Chi, L. Goumnerova, M. Proctor, N. J. Tarbell, et al. Moyamoya following cranial irradiation for primary brain tumors in children Neurology, March 20, 2007; 68(12): 932 - 938. [Abstract] [Full Text] [PDF]

				N. Purdie, J. Hattie, and A. Carroll A Review of the Research on Interventions for Attention Deficit Hyperactivity Disorder: What Works Best? Review of Educational Research, January 1, 2002; 72(1): 61 - 99. [Abstract] [PDF]

				J. A. Beckman, A. Thakore, B. H. Kalinowski, J. R. Harris, and M. A. Creager Radiation therapy impairs endothelium-dependent vasodilation in humans J. Am. Coll. Cardiol., March 1, 2001; 37(3): 761 - 765. [Abstract] [Full Text] [PDF]

				R. G. Floyd and E. A. Kirby Psychometric properties of measures of behavioral inhibition with preschool-age children: Implications for assessment of children at risk for ADHD J Atten Disord, January 1, 2001; 5(2): 79 - 91. [Abstract] [PDF]