Radiation-induced rhombencephalopathy.
We report the case of a patient who underwent radiotherapy of the neck because of an epidermoid carcinoma in Rosenmuller's fossa. Eleven months later, T1-weighted brain magnetic resonance imaging (MRI) revealed a bulbo-pontine lesion, and the clinical course and sequential MRI results led to a diagnosis of radionecrosis-induced rhombencephalopathy. At a distance of more than three years, the lesion is no longer visible on MRI images but the severe neurological deficits remain. The clinical picture has not been improved by treatment with prednisone, hyperbaric oxygen, symptomatic therapies or anticoagulants.
Cirafisi
C
C
Anaesthesia, Intensive Care and Hyperbaric Chamber Service, United Civil Hospitals, Sciacca (AG), Italy.
Verderame
F
F
D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy*; D002524:Cerebellar Ataxia / Q000209:etiology*; D003389:Cranial Nerve Diseases / Q000209:etiology*; D005071:Evoked Potentials; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D006931:Hyperbaric Oxygenation; D008279:Magnetic Resonance Imaging; D008297:Male; D009336:Necrosis; D009759:Nystagmus, Pathologic / Q000209:etiology; D010291:Paresis / Q000209:etiology*; D010610:Pharyngeal Neoplasms / Q000532:radiotherapy*; D011149:Pons / Q000473:pathology / Q000528:radiation effects; D011832:Radiation Injuries / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D011878:Radiotherapy / Q000009:adverse effects*; D012249:Rhombencephalon / Q000473:pathology / Q000528:radiation effects*
D000925:Anticoagulants; D006493:Heparin