title: Post-irradiation lumbosacral radiculopathy associated with multiple cavernous malformations of the cauda equina: Case report and review of the literature.
abstract: BACKGROUND
  Multiple radiation-induced cavernous malformations of the cauda equina are extremely rare. A review of the literature suggested that the post-irradiation lumbosacral radiculopathy in our patient was most likely associated with a diagnosis of multiple radiation-induced cavernous malformations of the cauda equina.
  
  
  METHODS
  A 76-year-old man with a remote history of abdominal radiation therapy presented with a 6-month history of progressively worsening right foot drop and balance impairment. Magnetic resonance imaging (MRI) revealed multiple enhancing areas of the cauda equina concerning for carcinomatous meningitis, however, cerebrospinal fluid (CSF) analysis was unrevealing. Intraoperative findings were consistent with multiple radiation-induced cavernous malformations of the cauda equina.
  
  
  CONCLUSIONS
  Multiple radiation-induced cavernous malformations of the cauda equina may mimic carcinomatous or infectious meningitis. Clinicians should be suspicious of this diagnosis when CSF and MRI findings are inconsistent with metastatic disease or infectious meningitis in patients who present with radiculopathy and a history of radiation therapy.
authors.affiliation: Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California.
authors.forename: Doniel
authors.initials: D
authors.lastname: Drazin
authors.affiliation: School of Medicine, Stony Brook University, New York, USA.
authors.forename: Ari
authors.initials: A
authors.lastname: Kappel
authors.affiliation: Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California.
authors.forename: Stefan
authors.initials: S
authors.lastname: Withrow
authors.affiliation: Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California.
authors.forename: Tiffany
authors.initials: T
authors.lastname: Perry
authors.affiliation: Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California.
authors.forename: Ray
authors.initials: R
authors.lastname: Chu
authors.affiliation: Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, California.
authors.forename: Surasak
authors.initials: S
authors.lastname: Phuphanich
keywords: Cauda equina; cavernous malformation; radiculopathy; radiotherapy; spine