Unexpected Cerebral Hyperperfusion after Transient Hypoperfusion Associated with Stroke-like Migraine Attacks after Radiation Therapy Syndrome

IRIZATO, Naoki; HASHIMOTO, Hiroaki; CHIBA, Yasuyoshi

NMC Case Report Journal, 2024, 11, 135-140

アクセス数:420件（2025-07-14 20:14 集計）

固定URL: https://hdl.handle.net/11094/96430

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タイトル
Unexpected Cerebral Hyperperfusion after Transient Hypoperfusion Associated with Stroke-like Migraine Attacks after Radiation Therapy Syndrome
著者
著者名
IRIZATO, Naoki
NRID
1000050770674 1000050770674
ORCID
0000-0003-4057-4466 0000-0003-4057-4466
researchmap permalink
yousyou0720 yousyou0720
Scopus Author ID
56922570200 56922570200
著者名
HASHIMOTO, Hiroaki
NRID
1000090533795 1000090533795
著者名
CHIBA, Yasuyoshi
キーワード等
SMART syndrome
hemiplegic migraine
arterial spin labeling
radiotherapy
内容
IRIZATO Naoki, HASHIMOTO Hiroaki, CHIBA Yasuyoshi. Unexpected Cerebral Hyperperfusion after Transient Hypoperfusion Associated with Stroke-like Migraine Attacks after Radiation Therapy Syndrome. NMC Case Report Journal 11, 135 (2024); https://doi.org/10.2176/jns-nmc.2024-0037.
抄録
Stroke-like migraine attacks after radiation therapy (SMART) syndrome, a delayed sequela of cranial radiotherapy encountered rarely, occurs due to transient neurological deficits coupled with migraine episodes. This case report describes an occurrence of SMART syndrome in an individual 8 years after receiving medulloblastoma treatment. The subject, a 21-year-old male, experienced abrupt aphasia and right-sided hemiparesis. Arterial spin labeling (ASL) revealed initial cerebral hypoperfusion in the left temporal and parietal regions, with no tumor resurgence or notable ischemic alterations. Two days later, the symptoms disappeared completely; nevertheless, at that time, ASL presented cerebral hyperperfusion in the same lobule. The subject experienced a pulsating headache and nausea the next day. In the context of SMART syndrome, this fluctuation in cerebral blood flow indicated by ASL is a unique finding. The significance of this case lies in the documentation of the dynamic evolution of cerebral perfusion in SMART syndrome via ASL, thereby elucidating its underlying pathophysiology. As hemiplegic migraine shows a similar cerebral perfusion pattern to SMART syndrome, we inferred an unexplored but shared pathophysiology among hemiplegic migraine and SMART syndrome. Through this successful capture of these distinct cerebral blood flow alterations, from hypoperfusion to hyperperfusion, our understanding of the pathophysiological intricacies inherent to SMART syndrome will be enhanced.
出版者
Japan Neurosurgical Society
収録物名
NMC Case Report Journal
巻(号)
11
ページ
135-140
刊行年月
2024-03-15
言語
英語
ハンドルURL
https://hdl.handle.net/11094/96430
eISSN
21884226
関連情報 (isIdenticalTo)
DOI (出版社版)
https://doi.org/10.2176/jns-nmc.2024-0037
アクセス権
open access
権利情報
Ⓒ 2024 The Japan Neurosurgical Society. This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
出版タイプ
Version of Record
カテゴリ
学術雑誌論文 Journal Article