title: Cerebral hypoperfusion secondary to radiation arteritis presenting with recurrent syncope.
abstract: Radiation arteritis can lead to significant extracranial carotid artery stenosis, affecting the circle of Willis. Cerebral hypoperfusion due to arterial insufficiency is often considered as a differential diagnosis in cases of syncope but rarely proven. We present a case of a 61-year-old man with repeated episodes of syncope-negative cardiac investigations. He had a history of cervical radiation therapy for tonsillar squamous cell carcinoma 15 years previously. Carotid duplex revealed bilateral carotid occlusive disease. MR angiography showed severe multilevel extracranial carotid stenosis bilaterally with occluded left vertebral artery. A diagnosis of cerebral hypoperfusion was performed following single-photon emission CT scan. The patient underwent a left subclavian to carotid bypass, which alleviated his symptoms.
authors: Department of Vascular Surgery, Limerick University Hospital, Dublin, Ireland.
authors: Khalid
authors: K
authors: Bashar
authors: Department of Vascular Surgery, Limerick University Hospital, Limerick, Ireland.
authors: Seamus
authors: S
authors: McHugh
authors: Department of Vascular Surgery, Limerick University Hospital, Limerick, Ireland.
authors: Paul
authors: P
authors: Burke
authors: Department of Vascular Surgery, Limerick University Hospital, Limerick, Ireland.
authors: Eamon
authors: E
authors: Kavanagh
mesh_terms: D001167:Arteritis / Q000150:complications / Q000175:diagnosis*; D002545:Brain Ischemia / Q000175:diagnosis / Q000209:etiology; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy*; D016893:Carotid Stenosis / Q000150:complications / Q000175:diagnosis*; D002533:Cerebral Angiography; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D011832:Radiation Injuries / Q000150:complications / Q000175:diagnosis*; D000077195:Squamous Cell Carcinoma of Head and Neck; D013575:Syncope / Q000209:etiology*; D015899:Tomography, Emission-Computed, Single-Photon; D014067:Tonsillar Neoplasms / Q000532:radiotherapy*; D014715:Vertebrobasilar Insufficiency / Q000175:diagnosis* / Q000209:etiology