Presentation
History of meningioma resection 20 years ago and treated with radiotherapy. Headache and visual disturbances of 3 weeks of evolution
Patient Data
Prominent right occipital and parietal lobes cortical thickening and hyperintensity on axial FLAIR and T2 image with gyriform enhancement on T1W image after gadolinium administration without respecting vascular territories. No diffusion restriction.
Biparietal postsurgical encephalomalacia.
Case Discussion
In this context, the findings are considered compatible with SMART syndrome (stroke-like migraine attacks after radiation therapy). SMART syndrome is an infrequent late complication of radiation therapy that has been linked to microvascular dysfunction.
Symptoms and brain MRI abnormalities tend to be transient.
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