SMART syndrome: Classic transient symptoms leading to an unusual unfavorable outcome
Stroke-like migraine attacks after radiation therapy (SMART) syndrome is a rare complication of cerebral radiation therapy that usually presents>10 years after treatment as reversible paroxysmal episodes of neurological dysfunction associated with headaches. We report here on two cases of SMART s...
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| Veröffentlicht in: | Revue neurologique 2017-01, Vol.173 (1-2), p.67-73 |
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| container_title | Revue neurologique |
| container_volume | 173 |
| creator | Bompaire, F. Zinchenko, L. Lahutte, M. Mokhtari, K. Psimaras, D. Gaultier, C. Monjour, A. Delattre, J.-Y. Ricard, D. |
| description | Stroke-like migraine attacks after radiation therapy (SMART) syndrome is a rare complication of cerebral radiation therapy that usually presents>10 years after treatment as reversible paroxysmal episodes of neurological dysfunction associated with headaches.
We report here on two cases of SMART syndrome in long-term survivors of high-grade glioma for whom neuropathological data were available. The course of the disease was unfavorable. Although the clinico-radiological picture of SMART syndrome clearly differs from classic cerebral radionecrosis, the gross neuropathological lesions observed in our two patients appeared to be similar to those described in focal radionecrosis.
SMART syndrome may progress from a benign reversible form to a severe and eventually irreversible form. This severe course may also be confused with tumor progression, and lead to permanent disability and inadequate antitumor treatment. Clinicians should be aware of this latter atypical presentation. |
| doi_str_mv | 10.1016/j.neurol.2016.09.014 |
| format | Article |
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We report here on two cases of SMART syndrome in long-term survivors of high-grade glioma for whom neuropathological data were available. The course of the disease was unfavorable. Although the clinico-radiological picture of SMART syndrome clearly differs from classic cerebral radionecrosis, the gross neuropathological lesions observed in our two patients appeared to be similar to those described in focal radionecrosis.
SMART syndrome may progress from a benign reversible form to a severe and eventually irreversible form. This severe course may also be confused with tumor progression, and lead to permanent disability and inadequate antitumor treatment. Clinicians should be aware of this latter atypical presentation.</description><identifier>ISSN: 0035-3787</identifier><identifier>DOI: 10.1016/j.neurol.2016.09.014</identifier><identifier>PMID: 27919464</identifier><language>eng</language><publisher>France: Elsevier Masson SAS</publisher><subject>Adult ; Aura ; Brain Neoplasms - radiotherapy ; Fatal Outcome ; Female ; Glioma - radiotherapy ; Headache - diagnosis ; Headache - etiology ; Humans ; Male ; Middle Aged ; Migraine Disorders - diagnosis ; Migraine Disorders - etiology ; Paraneoplastic Syndromes, Nervous System - diagnosis ; Paraneoplastic Syndromes, Nervous System - etiology ; Radiation Injuries - complications ; Radionecrosis ; Radiotherapy ; Stroke - diagnosis ; Stroke - etiology ; Stroke-like migraine attack</subject><ispartof>Revue neurologique, 2017-01, Vol.173 (1-2), p.67-73</ispartof><rights>2016 Elsevier Masson SAS</rights><rights>Copyright © 2016 Elsevier Masson SAS. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c362t-5fe18e4ef56c116e7b1d713778c3e6ee95c26d09f345c9b373dc44ffcdcb041a3</citedby><cites>FETCH-LOGICAL-c362t-5fe18e4ef56c116e7b1d713778c3e6ee95c26d09f345c9b373dc44ffcdcb041a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.neurol.2016.09.014$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3549,27923,27924,45994</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27919464$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bompaire, F.</creatorcontrib><creatorcontrib>Zinchenko, L.</creatorcontrib><creatorcontrib>Lahutte, M.</creatorcontrib><creatorcontrib>Mokhtari, K.</creatorcontrib><creatorcontrib>Psimaras, D.</creatorcontrib><creatorcontrib>Gaultier, C.</creatorcontrib><creatorcontrib>Monjour, A.</creatorcontrib><creatorcontrib>Delattre, J.-Y.</creatorcontrib><creatorcontrib>Ricard, D.</creatorcontrib><title>SMART syndrome: Classic transient symptoms leading to an unusual unfavorable outcome</title><title>Revue neurologique</title><addtitle>Rev Neurol (Paris)</addtitle><description>Stroke-like migraine attacks after radiation therapy (SMART) syndrome is a rare complication of cerebral radiation therapy that usually presents>10 years after treatment as reversible paroxysmal episodes of neurological dysfunction associated with headaches.
We report here on two cases of SMART syndrome in long-term survivors of high-grade glioma for whom neuropathological data were available. The course of the disease was unfavorable. Although the clinico-radiological picture of SMART syndrome clearly differs from classic cerebral radionecrosis, the gross neuropathological lesions observed in our two patients appeared to be similar to those described in focal radionecrosis.
SMART syndrome may progress from a benign reversible form to a severe and eventually irreversible form. This severe course may also be confused with tumor progression, and lead to permanent disability and inadequate antitumor treatment. Clinicians should be aware of this latter atypical presentation.</description><subject>Adult</subject><subject>Aura</subject><subject>Brain Neoplasms - radiotherapy</subject><subject>Fatal Outcome</subject><subject>Female</subject><subject>Glioma - radiotherapy</subject><subject>Headache - diagnosis</subject><subject>Headache - etiology</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Migraine Disorders - diagnosis</subject><subject>Migraine Disorders - etiology</subject><subject>Paraneoplastic Syndromes, Nervous System - diagnosis</subject><subject>Paraneoplastic Syndromes, Nervous System - etiology</subject><subject>Radiation Injuries - complications</subject><subject>Radionecrosis</subject><subject>Radiotherapy</subject><subject>Stroke - diagnosis</subject><subject>Stroke - etiology</subject><subject>Stroke-like migraine attack</subject><issn>0035-3787</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kM9LwzAUx3NQ3Jz-ByI9ellNmjRpPQhj-Asmgs5zSJNX6WibmaSD_fdmdHr09Hi87w_eB6ErglOCCb_dpD0MzrZpFrcUlykm7ARNMab5nIpCTNC59xuMMyIwPUOTTJSkZJxN0frjdfG-Tvy-N852cJcsW-V9o5PgVO8b6EO8ddtgO5-0oEzTfyXBJqpPhn7wg2rjrNXOOlW1kNgh6JhygU5r1Xq4PM4Z-nx8WC-f56u3p5flYjXXlGdhntdACmBQ51wTwkFUxAhChSg0BQ5Q5jrjBpc1ZbkuKyqo0YzVtTa6wowoOkM3Y-7W2e8BfJBd4zW0rerBDl6SgnHK84KTKGWjVDvrvYNabl3TKbeXBMsDQ7mRI0N5YChxKSPDaLs-NgxVB-bP9AswCu5HAcQ_dw046XWkpsE0DnSQxjb_N_wAVt2IGw</recordid><startdate>201701</startdate><enddate>201701</enddate><creator>Bompaire, F.</creator><creator>Zinchenko, L.</creator><creator>Lahutte, M.</creator><creator>Mokhtari, K.</creator><creator>Psimaras, D.</creator><creator>Gaultier, C.</creator><creator>Monjour, A.</creator><creator>Delattre, J.-Y.</creator><creator>Ricard, D.</creator><general>Elsevier Masson SAS</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>7X8</scope></search><sort><creationdate>201701</creationdate><title>SMART syndrome: Classic transient symptoms leading to an unusual unfavorable outcome</title><author>Bompaire, F. ; Zinchenko, L. ; Lahutte, M. ; Mokhtari, K. ; Psimaras, D. ; Gaultier, C. ; Monjour, A. ; Delattre, J.-Y. ; Ricard, D.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c362t-5fe18e4ef56c116e7b1d713778c3e6ee95c26d09f345c9b373dc44ffcdcb041a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Aura</topic><topic>Brain Neoplasms - radiotherapy</topic><topic>Fatal Outcome</topic><topic>Female</topic><topic>Glioma - radiotherapy</topic><topic>Headache - diagnosis</topic><topic>Headache - etiology</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Migraine Disorders - diagnosis</topic><topic>Migraine Disorders - etiology</topic><topic>Paraneoplastic Syndromes, Nervous System - diagnosis</topic><topic>Paraneoplastic Syndromes, Nervous System - etiology</topic><topic>Radiation Injuries - complications</topic><topic>Radionecrosis</topic><topic>Radiotherapy</topic><topic>Stroke - diagnosis</topic><topic>Stroke - etiology</topic><topic>Stroke-like migraine attack</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bompaire, F.</creatorcontrib><creatorcontrib>Zinchenko, L.</creatorcontrib><creatorcontrib>Lahutte, M.</creatorcontrib><creatorcontrib>Mokhtari, K.</creatorcontrib><creatorcontrib>Psimaras, D.</creatorcontrib><creatorcontrib>Gaultier, C.</creatorcontrib><creatorcontrib>Monjour, A.</creatorcontrib><creatorcontrib>Delattre, J.-Y.</creatorcontrib><creatorcontrib>Ricard, D.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Revue neurologique</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bompaire, F.</au><au>Zinchenko, L.</au><au>Lahutte, M.</au><au>Mokhtari, K.</au><au>Psimaras, D.</au><au>Gaultier, C.</au><au>Monjour, A.</au><au>Delattre, J.-Y.</au><au>Ricard, D.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>SMART syndrome: Classic transient symptoms leading to an unusual unfavorable outcome</atitle><jtitle>Revue neurologique</jtitle><addtitle>Rev Neurol (Paris)</addtitle><date>2017-01</date><risdate>2017</risdate><volume>173</volume><issue>1-2</issue><spage>67</spage><epage>73</epage><pages>67-73</pages><issn>0035-3787</issn><abstract>Stroke-like migraine attacks after radiation therapy (SMART) syndrome is a rare complication of cerebral radiation therapy that usually presents>10 years after treatment as reversible paroxysmal episodes of neurological dysfunction associated with headaches.
We report here on two cases of SMART syndrome in long-term survivors of high-grade glioma for whom neuropathological data were available. The course of the disease was unfavorable. Although the clinico-radiological picture of SMART syndrome clearly differs from classic cerebral radionecrosis, the gross neuropathological lesions observed in our two patients appeared to be similar to those described in focal radionecrosis.
SMART syndrome may progress from a benign reversible form to a severe and eventually irreversible form. This severe course may also be confused with tumor progression, and lead to permanent disability and inadequate antitumor treatment. Clinicians should be aware of this latter atypical presentation.</abstract><cop>France</cop><pub>Elsevier Masson SAS</pub><pmid>27919464</pmid><doi>10.1016/j.neurol.2016.09.014</doi><tpages>7</tpages></addata></record> |
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| source | MEDLINE; ScienceDirect Journals (5 years ago - present) |
| subjects | Adult Aura Brain Neoplasms - radiotherapy Fatal Outcome Female Glioma - radiotherapy Headache - diagnosis Headache - etiology Humans Male Middle Aged Migraine Disorders - diagnosis Migraine Disorders - etiology Paraneoplastic Syndromes, Nervous System - diagnosis Paraneoplastic Syndromes, Nervous System - etiology Radiation Injuries - complications Radionecrosis Radiotherapy Stroke - diagnosis Stroke - etiology Stroke-like migraine attack |
| title | SMART syndrome: Classic transient symptoms leading to an unusual unfavorable outcome |
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