Middle cerebral artery occlusion 25 years after cranial radiation therapy in acromegaly: a case report.
We report a case of ischemic stroke in a 43 year-old woman with no traditional cardiovascular risk factors and a history of cranial surgery and cranial radiation therapy (CRT) for a GH-secreting pituitary macroadenoma. The neurological work-up on this patient disclosed several cerebral ischemic lesions and demonstrated the occlusion of the right middle cerebral artery together with the narrowing of the right carotid artery; post-radiation brain damage was also visible by nuclear magnetic resonance. We postulate the existence in this patient of a radiation-induced vascular damage, which is a well recognized process thoroughly described in in vitro studies. We remark that life-long follow-up of acromegalic patients receiving CRT is essential so that early diagnosis of radiation-induced vascular injury can be made.
Maffei
P
P
Department of Medical and Surgical Sciences-3rd Internal Medicine, Padua University, Padua, Italy. pietromaffei@libero.it
Albano
I
I
Martini
C
C
Barban
M
M
Manara
R
R
Meneghetti
G
G
Sicolo
N
N
D000172:Acromegaly / Q000150:complications* / Q000532:radiotherapy; D000328:Adult; D005260:Female; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000209:etiology*; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D010911:Pituitary Neoplasms / Q000150:complications / Q000532:radiotherapy; D011832:Radiation Injuries; D011878:Radiotherapy / Q000009:adverse effects*