Lacunar stroke attributable to radiation-induced intracranial arteriopathy.
We report the rare presentation of lacunar stroke syndrome secondary to single perforator mouth occlusion from radiation-induced middle cerebral artery (MCA) stem arteriopathy. A 30-year-old female had acute-onset right-sided ataxic hemiparesis and dysarthria. As a child, she had a medulloblastoma of the posterior fossa and had surgery followed by cranial radiotherapy. She had no significant vascular risk factors. Acute CT showed extensive bilateral basal ganglia and left thalamic calcification; DWI showed a left internal capsule lacunar infarct; and MRA and CTA showed a 50% stenosis of the proximal left MCA.
Department of Clinical Neurosciences and Stroke Unit, University of Cambridge, Cambridge, UK.
I S M
IS
Salih
N J N
NJ
Higgins
E A
EA
Warburton
J-C
JC
Baron
D000328:Adult; D001479:Basal Ganglia / Q000473:pathology / Q000528:radiation effects; D020520:Brain Infarction / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D002114:Calcinosis / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D020772:Internal Capsule / Q000098:blood supply / Q000473:pathology / Q000503:physiopathology; D008527:Medulloblastoma / Q000532:radiotherapy; D020768:Middle Cerebral Artery / Q000473:pathology / Q000503:physiopathology / Q000528:radiation effects*; D011878:Radiotherapy / Q000009:adverse effects*; D013788:Thalamus / Q000473:pathology / Q000528:radiation effects; D014057:Tomography, X-Ray Computed