Brain Magnetic Resonance Spectroscopy Findings in the Stroke‐like Migraine Attacks after Radiation Therapy (SMART) Syndrome
ABSTRACT A 41‐year‐old male presented with an acute onset of headache, confusion, seizures, and unilateral focal neurological deficit 25 years after receiving whole‐brain radiation therapy to treat a cerebellar medulloblastoma. Brain magnetic resonance imaging (MRI) demonstrated a thick unilateral p...
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| Veröffentlicht in: | Journal of neuroimaging 2015-11, Vol.25 (6), p.1056-1058 |
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| container_title | Journal of neuroimaging |
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| creator | Gómez‐Cibeira, Emilio Calleja‐Castaño, Patricia Gonzalez de la Aleja, Jesus Sierra‐Hidalgo, Fernando Ruiz Morales, Juan Salvador‐Alvarez, Elena Ramos‐Gonzalez, Ana |
| description | ABSTRACT
A 41‐year‐old male presented with an acute onset of headache, confusion, seizures, and unilateral focal neurological deficit 25 years after receiving whole‐brain radiation therapy to treat a cerebellar medulloblastoma. Brain magnetic resonance imaging (MRI) demonstrated a thick unilateral parieto‐occipital cortical contrast enhancement. A diagnosis of “Stroke‐like Migraine Attacks after Radiation Therapy” (SMART) syndrome was made. Here, we describe the brain MR spectroscopy findings of SMART, showing a decrease in N‐acetyl‐aspartate and increased levels of creatine and choline, corresponding with neuronal destruction or transient neuronal impairment with mild nonspecific gliosis. The absence of a lactate peak suggests that mitochondrial dysfunction, vasospasm or ischemic mechanisms were not involved. |
| doi_str_mv | 10.1111/jon.12227 |
| format | Article |
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A 41‐year‐old male presented with an acute onset of headache, confusion, seizures, and unilateral focal neurological deficit 25 years after receiving whole‐brain radiation therapy to treat a cerebellar medulloblastoma. Brain magnetic resonance imaging (MRI) demonstrated a thick unilateral parieto‐occipital cortical contrast enhancement. A diagnosis of “Stroke‐like Migraine Attacks after Radiation Therapy” (SMART) syndrome was made. Here, we describe the brain MR spectroscopy findings of SMART, showing a decrease in N‐acetyl‐aspartate and increased levels of creatine and choline, corresponding with neuronal destruction or transient neuronal impairment with mild nonspecific gliosis. The absence of a lactate peak suggests that mitochondrial dysfunction, vasospasm or ischemic mechanisms were not involved.</description><identifier>ISSN: 1051-2284</identifier><identifier>EISSN: 1552-6569</identifier><identifier>DOI: 10.1111/jon.12227</identifier><identifier>PMID: 25702932</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Adult ; Brain - diagnostic imaging ; Cerebellar Neoplasms - radiotherapy ; Creatine ; Humans ; Magnetic Resonance Spectroscopy ; Male ; Medulloblastoma - radiotherapy ; Migraine ; Migraine Disorders - diagnostic imaging ; Migraine Disorders - etiology ; Neuroimaging ; NMR ; Nuclear magnetic resonance ; Radiation therapy ; Radiotherapy - adverse effects ; SMART ; stroke‐like migraine attacks after radiation therapy</subject><ispartof>Journal of neuroimaging, 2015-11, Vol.25 (6), p.1056-1058</ispartof><rights>Copyright © 2015 by the American Society of Neuroimaging</rights><rights>Copyright © 2015 by the American Society of Neuroimaging.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3867-b2470a0cba34eeac3ee0646b2180819aa8eb3f484e6967c0887a0cdb3fe688943</citedby><cites>FETCH-LOGICAL-c3867-b2470a0cba34eeac3ee0646b2180819aa8eb3f484e6967c0887a0cdb3fe688943</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjon.12227$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjon.12227$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25702932$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gómez‐Cibeira, Emilio</creatorcontrib><creatorcontrib>Calleja‐Castaño, Patricia</creatorcontrib><creatorcontrib>Gonzalez de la Aleja, Jesus</creatorcontrib><creatorcontrib>Sierra‐Hidalgo, Fernando</creatorcontrib><creatorcontrib>Ruiz Morales, Juan</creatorcontrib><creatorcontrib>Salvador‐Alvarez, Elena</creatorcontrib><creatorcontrib>Ramos‐Gonzalez, Ana</creatorcontrib><title>Brain Magnetic Resonance Spectroscopy Findings in the Stroke‐like Migraine Attacks after Radiation Therapy (SMART) Syndrome</title><title>Journal of neuroimaging</title><addtitle>J Neuroimaging</addtitle><description>ABSTRACT
A 41‐year‐old male presented with an acute onset of headache, confusion, seizures, and unilateral focal neurological deficit 25 years after receiving whole‐brain radiation therapy to treat a cerebellar medulloblastoma. Brain magnetic resonance imaging (MRI) demonstrated a thick unilateral parieto‐occipital cortical contrast enhancement. A diagnosis of “Stroke‐like Migraine Attacks after Radiation Therapy” (SMART) syndrome was made. Here, we describe the brain MR spectroscopy findings of SMART, showing a decrease in N‐acetyl‐aspartate and increased levels of creatine and choline, corresponding with neuronal destruction or transient neuronal impairment with mild nonspecific gliosis. The absence of a lactate peak suggests that mitochondrial dysfunction, vasospasm or ischemic mechanisms were not involved.</description><subject>Adult</subject><subject>Brain - diagnostic imaging</subject><subject>Cerebellar Neoplasms - radiotherapy</subject><subject>Creatine</subject><subject>Humans</subject><subject>Magnetic Resonance Spectroscopy</subject><subject>Male</subject><subject>Medulloblastoma - radiotherapy</subject><subject>Migraine</subject><subject>Migraine Disorders - diagnostic imaging</subject><subject>Migraine Disorders - etiology</subject><subject>Neuroimaging</subject><subject>NMR</subject><subject>Nuclear magnetic resonance</subject><subject>Radiation therapy</subject><subject>Radiotherapy - adverse effects</subject><subject>SMART</subject><subject>stroke‐like migraine attacks after radiation therapy</subject><issn>1051-2284</issn><issn>1552-6569</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkc1OGzEURq0K1ADtghdAltiQxRD_zHg8y4CaAiIgJel65PHcBCcTO9gTVVkg9RH6jH0SHAIskJDqjS3fc4_s-yF0TMk5jas3d_acMsbyL-iAZhlLRCaKvXgmGU0Yk2kHHYYwJ4TRlPGvqMOynLCCswP0dOGVsXioZhZao_EIgrPKasDjFejWu6DdaoMHxtbGzgKObPsQi7GygH9__jZmAXhoZlsL4H7bKr0IWE1b8HikaqNa4yyePIBXUXM2HvZHky4eb2zt3RK-of2pagJ8f92P0K_Bj8nlVXJ7__P6sn-baC5FnlQszYkiulI8BVCaAxCRiopRSSQtlJJQ8WkqUxCFyDWRMo90He9ASFmk_Aid7bwr7x7XENpyaYKGplEW3DqUNGf5tlUU_4PGyVHGt9bTD-jcrb2NH3mhuIgvIpHq7igdhxk8TMuVN0vlNyUl5Ta-2GXLl_gie_JqXFdLqN_Jt7wi0NsBv00Dm89N5c393U75DCkZpDw</recordid><startdate>201511</startdate><enddate>201511</enddate><creator>Gómez‐Cibeira, Emilio</creator><creator>Calleja‐Castaño, Patricia</creator><creator>Gonzalez de la Aleja, Jesus</creator><creator>Sierra‐Hidalgo, Fernando</creator><creator>Ruiz Morales, Juan</creator><creator>Salvador‐Alvarez, Elena</creator><creator>Ramos‐Gonzalez, Ana</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>7QP</scope><scope>7TK</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>201511</creationdate><title>Brain Magnetic Resonance Spectroscopy Findings in the Stroke‐like Migraine Attacks after Radiation Therapy (SMART) Syndrome</title><author>Gómez‐Cibeira, Emilio ; Calleja‐Castaño, Patricia ; Gonzalez de la Aleja, Jesus ; Sierra‐Hidalgo, Fernando ; Ruiz Morales, Juan ; Salvador‐Alvarez, Elena ; Ramos‐Gonzalez, Ana</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3867-b2470a0cba34eeac3ee0646b2180819aa8eb3f484e6967c0887a0cdb3fe688943</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Brain - diagnostic imaging</topic><topic>Cerebellar Neoplasms - radiotherapy</topic><topic>Creatine</topic><topic>Humans</topic><topic>Magnetic Resonance Spectroscopy</topic><topic>Male</topic><topic>Medulloblastoma - radiotherapy</topic><topic>Migraine</topic><topic>Migraine Disorders - diagnostic imaging</topic><topic>Migraine Disorders - etiology</topic><topic>Neuroimaging</topic><topic>NMR</topic><topic>Nuclear magnetic resonance</topic><topic>Radiation therapy</topic><topic>Radiotherapy - adverse effects</topic><topic>SMART</topic><topic>stroke‐like migraine attacks after radiation therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gómez‐Cibeira, Emilio</creatorcontrib><creatorcontrib>Calleja‐Castaño, Patricia</creatorcontrib><creatorcontrib>Gonzalez de la Aleja, Jesus</creatorcontrib><creatorcontrib>Sierra‐Hidalgo, Fernando</creatorcontrib><creatorcontrib>Ruiz Morales, Juan</creatorcontrib><creatorcontrib>Salvador‐Alvarez, Elena</creatorcontrib><creatorcontrib>Ramos‐Gonzalez, Ana</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of neuroimaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gómez‐Cibeira, Emilio</au><au>Calleja‐Castaño, Patricia</au><au>Gonzalez de la Aleja, Jesus</au><au>Sierra‐Hidalgo, Fernando</au><au>Ruiz Morales, Juan</au><au>Salvador‐Alvarez, Elena</au><au>Ramos‐Gonzalez, Ana</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Brain Magnetic Resonance Spectroscopy Findings in the Stroke‐like Migraine Attacks after Radiation Therapy (SMART) Syndrome</atitle><jtitle>Journal of neuroimaging</jtitle><addtitle>J Neuroimaging</addtitle><date>2015-11</date><risdate>2015</risdate><volume>25</volume><issue>6</issue><spage>1056</spage><epage>1058</epage><pages>1056-1058</pages><issn>1051-2284</issn><eissn>1552-6569</eissn><abstract>ABSTRACT
A 41‐year‐old male presented with an acute onset of headache, confusion, seizures, and unilateral focal neurological deficit 25 years after receiving whole‐brain radiation therapy to treat a cerebellar medulloblastoma. Brain magnetic resonance imaging (MRI) demonstrated a thick unilateral parieto‐occipital cortical contrast enhancement. A diagnosis of “Stroke‐like Migraine Attacks after Radiation Therapy” (SMART) syndrome was made. Here, we describe the brain MR spectroscopy findings of SMART, showing a decrease in N‐acetyl‐aspartate and increased levels of creatine and choline, corresponding with neuronal destruction or transient neuronal impairment with mild nonspecific gliosis. The absence of a lactate peak suggests that mitochondrial dysfunction, vasospasm or ischemic mechanisms were not involved.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>25702932</pmid><doi>10.1111/jon.12227</doi><tpages>3</tpages></addata></record> |
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| subjects | Adult Brain - diagnostic imaging Cerebellar Neoplasms - radiotherapy Creatine Humans Magnetic Resonance Spectroscopy Male Medulloblastoma - radiotherapy Migraine Migraine Disorders - diagnostic imaging Migraine Disorders - etiology Neuroimaging NMR Nuclear magnetic resonance Radiation therapy Radiotherapy - adverse effects SMART stroke‐like migraine attacks after radiation therapy |
| title | Brain Magnetic Resonance Spectroscopy Findings in the Stroke‐like Migraine Attacks after Radiation Therapy (SMART) Syndrome |
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