title: Acute hemorrhage in late radiation necrosis of the temporal lobe: report of five cases and review of the literature.
abstract: Hemorrhage in late cerebral radiation necrosis is a rare complication after radiotherapy for intracranial and extracranial neoplasms. We report 5 cases of acute hemorrhage in late radiation necrosis of the temporal lobe following radiation therapy for nasopharyngeal carcinoma. In a review of the literature, the authors identified a total of 27 such cases. The interval period between the onset of hemorrhage and cranial irradiation is long (mean = 7.8 years). The most prominent histological feature was the proliferation of large, dilated and thin-walled new blood vessels in a background of gliosis and fibrinoid necrosis of vessels. Rupture of these thin-walled new blood vessels is the proposed mechanism of hemorrhage in this condition.
authors.affiliation: Department of Neurosurgery, Queen Elizabeth Hospital, Kowloon, Hong Kong, China. chengkm@ha.org.hk
authors.forename: K M
authors.initials: KM
authors.lastname: Cheng
authors.forename: C M
authors.initials: CM
authors.lastname: Chan
authors.forename: Y T
authors.initials: YT
authors.lastname: Fu
authors.forename: L C
authors.initials: LC
authors.lastname: Ho
authors.forename: F C
authors.initials: FC
authors.lastname: Cheung
authors.forename: C K
authors.initials: CK
authors.lastname: Law
mesh_terms: D000328:Adult; D000368:Aged; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000532:radiotherapy*; D009336:Necrosis; D011832:Radiation Injuries / Q000150:complications* / Q000209:etiology / Q000473:pathology; D013702:Temporal Lobe / Q000601:surgery; D014057:Tomography, X-Ray Computed