This a case-report of a 45-year-old man who was operated on at age 16 for a left parietal low-grade astrocytoma. Due to the presence of cytonuclear abnormalities he was irradiated: 6Mv X-rays and a linear accelerator gave a dose of 55Gy over 36 days in 22 fractions, i.e. 2.50 Gy per fraction with 4 sessions per week. 2 years post-operatively he developed infrequent motor and somatosensory seizures. CTs were performed yearly and showed no tumour recurrence that was associated with a normal clinical examination. Seven years post-operatively calcification appeared in the irradiated area.
At age 39, he presented with a right hemiplegia and sensory abnormalities with an hemianopia that progressively improved. CT sacnning and FLAIR-MRI confirmed a diagnosis of left parieto-occipital infarction. MR angiography showed irregularity of the left posteror cerebral artey which arose from the internal carotid. The heart and all other arteries, including those of the neck were normal.
The paper discusses other reported cases of long-delayed arterial events after cranial irradiation, the pathological features of the arteries and the recently reported cases of cervical radiation-induced arteritis treated by stenting.
© 2007 Elsevier Masson SAS. Tous droits réservés.