[A patient with Moyamoya-like vessels after radiation therapy for a tumor in the basal ganglia].
A patient with Moyamoya-like vessels after radiation therapy for treatment of a tumor in the basal ganglia is reported. He was diagnosed as Down syndrome at birth. He had a tumor in the left basal ganglionic region at 12 years of the age. The tumor increased in size at age 14. He underwent cerebral angiography, which did not show a stenosis nor occlusion of the internal carotid artery, anterior cerebral artery, nor the middle cerebral artery. He received radiation therapy with a total dose of 56 Gy. He presented a dressing apraxia at age 19. MRI showed cerebral infarction in the left temporo-occipital region. Right internal carotid angiography revealed a severe stenosis of the internal carotid artery and anterior cerebral artery as well as a severe stenosis of the middle cerebral artery on the right side. Moyamoya-like vessels were seen in the basal ganglionic region. Left internal carotid angiography also showed a stenosis of the internal carotid artery and anterior cerebral artery as well as a severe stenosis of the middle cerebral artery on the left side. Moyamoya-like vessels were seen in the basal ganglionic region. Leptomeningeal anastomose and transdural anastomose were bilaterally seen. These arterial occlusion and stenotic phenomenon corresponded to a previous radiation field. These Moyamoya-like vessels with arterial stenosis and occlusion were thought to be due to radiation-induced vasculopathy, because a previous cerebral angiography showed a normal caliber of cerebral arteries. This patient showed that patients with radiation therapy in their early childhood should be carefully observed considering the possibility of this phenomenon.
Ishiyama
K
K
Department of Radiology, Akita University School of Medicine, 1-1-1, Hondo, Akita City, Akita 010-8543, Japan.
Tomura
N
N
Kato
K
K
Takahashi
S
S
Watarai
J
J
Sasajima
T
T
Mizoi
K
K
D000328:Adult; D001479:Basal Ganglia / Q000473:pathology*; D001932:Brain Neoplasms / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D009072:Moyamoya Disease / Q000000981:diagnostic imaging / Q000209:etiology*; D011832:Radiation Injuries / Q000000981:diagnostic imaging / Q000209:etiology*; D011859:Radiography; D011878:Radiotherapy / Q000009:adverse effects*