Multiple causes of cerebrovascular events in children with tumors of the parasellar region.
Cerebrovascular arterial occlusion is a rare but devastating event causing long-term morbidity in children with tumors in the parasellar region. While usually associated with radiation therapy, there are a variety of host, tumor and treatment factors which predispose patients to significant vasculopathy. Case reports of 5 patients from St. Jude Children's Research Hospital with tumors in the parasellar region who presented with or developed vascular occlusive disease are summarized. Multiple factors are identified in these cases which probably impacted on the development of cerebral arterial occlusion with or without moyamoya syndrome. These include, but are not limited to, neurofibromatosis, tumor encasement of major cerebral vessels, surgical alterations, and radiation therapy. The literature supports multiple, potentially interactive etiologies for the development of vascular events in these patients, suggesting that their development is not simply a phenomenon related to radiation therapy.
Rudoltz
M S
MS
Department of Radiation Oncology, University of Pennsylvania, Philadelphia 19104, USA.
Regine
W F
WF
Langston
J W
JW
Sanford
R A
RA
Kovnar
E H
EH
Kun
L E
LE
D001932:Brain Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000532:radiotherapy; D002533:Cerebral Angiography; D002561:Cerebrovascular Disorders / Q000175:diagnosis / Q000209:etiology*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D011832:Radiation Injuries / Q000150:complications; D012658:Sella Turcica; D014057:Tomography, X-Ray Computed