A Cross-Sectional Cohort Study of Cerebrovascular Disease and Late Effects After Radiation Therapy for Craniopharyngioma

Abstract

Patients with craniopharyngioma treated with RT have a high prevalence of stroke and vascular abnormalities, particularly those with low HDL and longer duration of time since RT. There is a trend to suggest that continual GH replacement may reduce the risk of stroke. These patients should undergo careful monitoring and aggressive modification of stroke risk factors.

Clinical outcomes following proton therapy for children with central nervous system tumors referred overseas

“…Serious toxicity was limited and no unexpected side effects were observed. Specifically, the rates of symptomatic brainstem necrosis and vasculopathy in this cohort were comparable to reports of children treated with photons over the past 5 years …”

“…Specifically, the rates of symptomatic brainstem necrosis and vasculopathy in this cohort were comparable to reports of children treated with photons over the past 5 years. [40][41][42][43][44][45][46] Taken in a historical context, these outcomes are remarkable: In the 21st century, children with brain tumors can be treated on a distant continent with no apparent compromise in care. The rapid, accurate transmission of medical information and fluid communication between multidisciplinary transcontinental medical teams reflects technological development on the same scale as particle therapy.…”

Vascular complications in pediatric craniopharyngioma patients: a case-based update

“…Regarding other vascular complications, the development of pseudoaneurysms and aneurysms has been described several years after brain irradiation [3,15]. Aneurysm development seems less common compared with vascular stenosis development after radiation therapy [15].…”

“…Most of the vascular complications seem to be diagnosed on routine follow-up. Long-term effects in children manifesting as stroke, lacunar lesions, stenosis of the middle cerebral artery, internal carotid artery, anterior cerebral artery, cavernomas, and moyamoya syndrome have been described [1,15,17]. MR angiograms should also be included in the routine follow-up, and since many of the vascular complications give strokelike symptoms, the threshold for performing perfusion imaging should be low [13].…”

“…Furthermore, patients with craniopharyngioma treated with RT experience a high rate of stroke compared with the normal population [15,27]. The rates of vascular abnormalities and stroke increase with time after RT [15]. The cumulative incidence of moyamoya syndrome after RT for brain tumors has been described to be 14.8% at 7 years of disease [17].…”