title: [Reversible neurological deficit years after high grade glioma--the SMART syndrome].
abstract: BACKGROUND
  Survival in patients with high grade glioma has been extended in recent years as a result of more intensive therapy. As a consequence, more late term complications of treatment may be observed.
  
  
  METHODS
  A 69-year-old woman presented at the outpatient department of Neurology with headache and loss of strength in the left arm. She had been treated 7 years previously for a high grade glioma with resection and radiotherapy. One year later she had received chemotherapy for a local recurrence. Since then she was free of complaints. At investigation a left sided hemiparesis was found. As recurrence of the tumour was suspected, MR imaging of the brain was performed, which showed abnormalities suggestive for the so called 'stroke-like migraine attacks after radiotherapy' (SMART) syndrome. The further clinical course, with spontaneous recovery of strength within a few weeks and the regression of the cortical hyperintensity on MRI, confirmed the probable diagnosis.
  
  
  CONCLUSIONS
  The SMART syndrome is a relatively unknown condition and should be included in the differential diagnosis in patients who present with new complaints long after cerebral radiotherapy.
authors: VU Medisch Centrum, Afd. Neurologie, Amsterdam, the Netherlands. f.e.bleeker@amc.uva.nl
authors: Fonnet  E
authors: F
authors: Bleeker
authors: Joseph  C J
authors: J
authors: Bot
authors: Hanneke E
authors: HE
authors: Ronner
authors: Tjeerd J
authors: TJ
authors: Postma
mesh_terms: D000368:Aged; D001921:Brain / Q000187:drug effects; D001932:Brain Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D005910:Glioma / Q000532:radiotherapy* / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008881:Migraine Disorders / Q000175:diagnosis / Q000209:etiology*; D011878:Radiotherapy / Q000009:adverse effects*; D020521:Stroke / Q000175:diagnosis / Q000209:etiology*