Subacute brain atrophy after radiation therapy for malignant brain tumor

Journal Article · Mon May 15 00:00:00 EDT 1989 · Cancer (Philadelphia); (United States)

DOI:https://doi.org/10.1002/1097-0142(19890515)63:10<1962::AID-CNCR2820631016>3.0.CO;2-V· OSTI ID:5986824

Asai, A; Matsutani, M; Kohno, T; Nakamura, O; Tanaka, H; Fujimaki, T; Funada, N; Matsuda, T; Nagata, K; Takakura, K

Brain atrophy with mental and neurologic deterioration developing a few months after radiation therapy in patients without residual or recurrent brain tumors has been recognized. Two illustrative case reports of this pathologic entity are presented. Six autopsy cases with this entity including the two cases were reviewed neurologically, radiographically, and histopathologically. All patients presented progressive disturbances of mental status and consciousness, akinesia, and tremor-like involuntary movement. Computerized tomography (CT) demonstrated marked enlargement of the ventricles, moderate widening of the cortical sulci, and a moderately attenuated CT number for the white matter in all six patients. Four of the six patients had CSF drainage (ventriculoperitoneal shunt or continuous lumbar drainage), however, none of them improved. Histologic examination demonstrated swelling and loss of the myelin sheath in the white matter in all patients, and reactive astrocytosis in three of the six patients. Neither prominent neuronal loss in the cerebral cortex or basal ganglia, nor axonal loss in the white matter was generally identified. The blood vessels of the cerebral cortex and white matter were normal. Ependymal layer and the surrounding brain tissue were normal in all patients. These findings suggested that this pathologic condition results from demyelination secondary to direct neurotoxic effect of irradiation. The authors' previous report was reviewed and the differential diagnoses, the risk factors for this pathologic entity, and the indication for radiation therapy in aged patients with a malignant brain tumor are discussed.

• Research Organization: Metropolitan Komagome Hospital, Tokyo (Japan)
• OSTI ID: 5986824
• Journal Information: Cancer (Philadelphia); (United States), Vol. 63:10
• Country of Publication: United States
• Language: English

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63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
BRAIN
BIOLOGICAL RADIATION EFFECTS
NEOPLASMS
RADIOTHERAPY
SIDE EFFECTS
AGED ADULTS
ATROPHY
AUTOPSY
COMPUTERIZED TOMOGRAPHY
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PATIENTS
RADIATION INJURIES
BIOLOGICAL EFFECTS
BODY
CENTRAL NERVOUS SYSTEM
DIAGNOSTIC TECHNIQUES
DISEASES
INJURIES
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NERVOUS SYSTEM
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ORGANS
RADIATION EFFECTS
RADIOLOGY
THERAPY
TOMOGRAPHY
560151* - Radiation Effects on Animals- Man