Delayed radionecrosis of the brain following therapeutic x-irradiation of the pituitary

Journal Article · Sun Jan 01 04:00:00 EST 1961 · Brain (Journal of Neurology)

DOI:https://doi.org/10.1093/brain/84.1.85· OSTI ID:4769907

CROMPTON, M. R.; LAYTON, D. D.

Clinical and pathological findings are described in 2 cases of delayed radionecrosrs of the brain following the irradiation of the contents of the pituitary fossa. They consisted of the recurrence of visual symptoms and the recurrence or onset of hypothalamic symptoms; of visual field defects unlike those usually seen in the recurrence of a pituitary adenoma; of necrosis of the hypothalamus, the inferomedial portions of the frontal lobes, the uncal gyri and the optic chiasm. The necrotic areas were characterized by the presence of a widespread, dense exudate of fibrin and degenerative and occlusive changes in the vessels. A region of degenerative change of grey and white matter containing narrowed and occluded vessels, lay adjacent to the central necrotic regions. The possible pathogenesis of delayed radiation necrosis on an allergic basis is suggested on the basis of these findings. Some or all of these appearances are seen in many conditions, throughout the body, in which the pathogenesis is thought to be allergic or due to hypersensitivity. The allergen may be the altered proteins of injured cells themselves. Thus there is evidence of alteration in the proteins of cells following iraadiation and it is suggested that delayed radiation necrosis of the brain may be an allergic reaction to these altered proteins. The 2 cases showed the characteristic latent period between the cessation of x-ray therapy and the onset of terminal symptoms. The latent period was shorter in the case receiving the lower dosage of irradiation, which is unusual and for which no explanation can be given. Changes in the visual fields were unlike those usually seem in tumor recurrence and were similar to those sometimes seen in vascular disease of the optic nerves and chiasm.

• Research Organization: National Hospital for Nervous Diseases, London
• Sponsoring Organization: USDOE
• NSA Number: NSA-16-032767
• OSTI ID: 4769907
• Journal Information: Brain (Journal of Neurology), Journal Name: Brain (Journal of Neurology) Journal Issue: 1 Vol. 84; ISSN 0006-8950
• Country of Publication: Country unknown/Code not available
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
ALLERGY
ANTIBODIES
BLOOD VESSELS
BRAIN
CYTOLOGY
DISEASES
EYES
FIBRIN
GLANDS
HYPOTHALAMUS
IMMUNITY
MEDICINE
NERVOUS SYSTEM
PHYSIOLOGY
PITUITARY GLAND
PROTEINS
RADIATION DOSES
RADIATION INJURIES
RADIOSENSITIVITY
RADIOTHERAPY
TUMORS
X RADIATION