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

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• 作者：J. A. Molad ; D. T. Blumenthal ; F. Bokstein ; M. Findler…
• 关键词：Cerebral microinfarct ; Small vessel disease ; Post ; radiation leukoencephalopathy
• 刊名：Journal of Neuro-Oncology
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：131
• 期：2
• 页码：277-281
• 全文大小：
• 刊物类别：Medicine
• 刊物主题：Oncology; Neurology;
• 出版者：Springer US
• ISSN：1573-7373
• 卷排序：131

文摘

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.