Silent Lacunar Lesions Detected by Magnetic Resonance Imaging of Children With Brain Tumors: A Late Sequela of Therapy

Fouladi, Maryam; Langston, J. William; Mulhern, Raymond K.; Jones, Dana; Xu, Xiaoping; Yang, Jianping; Thompson, Stephen A.; Walter, Andrew W.; Heideman, Richard L.; Kun, Larry E.; Gajjar, Amar

doi:10.1200/jco.2000.18.4.824

Cited by 80 publications

(47 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Young age and CRT may not be the only factors leading to a reported decline in cognitive function. For example, cognitive deficits or low IQ may be predicted by radiation dosimetry [27], tumour location [7,42]; pre-or perioperative brain damage [7] or presence of lacunae [38]. The presence and management of hydrocephalus are also implicated as factors effecting cognitive outcome [29]; however, Davis et al [22] did not replicate this finding with no consistent effect of hydrocephalus on outcome demonstrated.…”

Section: Discussioncontrasting

confidence: 39%

Recommendations for Assessing Cognitive Risks in Young Children Treated for Ependymoma for Clinical and Research Protocols: Evidence from a Systematic Literature Review

Morrall¹

2014

J. Pediatr. Oncol.

View full text Add to dashboard Cite

. (2014) Recommendations for assessing cognitive risks in young children treated for ependymoma for clinical and research protocols: evidence from a systematic literature review. Journal of Pediatric Oncology, 2 (1). pp. 24-39. ISSN 2309-3021 Access from the University of Nottingham repository: http://eprints.nottingham.ac.uk/34633/1/JPOV2N1A4-Morrall.pdf Copyright and reuse:The Nottingham ePrints service makes this work by researchers of the University of Nottingham available open access under the following conditions. This article is made available under the Creative Commons Attribution Non-commercial licence and may be reused according to the conditions of the licence. For more details see: http://creativecommons.org/licenses/by-nc/2.5/ A note on versions:The version presented here may differ from the published version or from the version of record. If you wish to cite this item you are advised to consult the publisher's version. Please see the repository url above for details on accessing the published version and note that access may require a subscription.For more information, please contact eprints@nottingham.ac.uk European approaches use chemotherapy to avoid or defer radiotherapy until three years of age, in order to avoid late neurocognitive toxicity. To establish evidence for the effects of cranial radiotherapy in children aged <36 months with ependymoma on neurocognitive outcomes, we conducted a systematic literature review assessing methodological approaches for measuring neurocognitive outcome. Methods: Eight databases were selected to perform an advanced search, retrieval and systematic review of papers describing neurocognitive outcome in children diagnosed with ependymoma who received cranial radiotherapy at <36 months. Results: Limitations of published data permitted descriptive analysis only. Considerable variation in reporting survival rates, techniques and timing of psychometric testing and the results of neurocognitive outcomes was identified. Conclusions: The review identified significant inconsistencies of neurocognitive testing, particularly literacy skills, developmental time points for testing and methods of data reporting. The role of the cerebellum for cognitive development, especially reading, has been inadequately evaluated in published studies. Recommendations are made to improve assessment methods, and time points for testing, so that reports do not fail to identify children who acquire deficits as they mature through childhood and adolescence. We conclude that claims that radiation treatment for ependymoma administered aged <36 months is associated with limited neurocognitive consequences, are not supported by the literature.

show abstract

Section: Discussioncontrasting

confidence: 39%

Recommendations for Assessing Cognitive Risks in Young Children Treated for Ependymoma for Clinical and Research Protocols: Evidence from a Systematic Literature Review

Morrall¹

2014

J. Pediatr. Oncol.

View full text Add to dashboard Cite

show abstract

“…Fouladi and coworkers studied a cohort of 524 consecutively treated pediatric patients with brain tumors to evaluate the incidence and impact of lacunar lesions [28]. Lacunar lesions represent ischemic infarcts of restricted size in the deep parenchyma of the brain.…”

Section: Incidence and Risk Factorsmentioning

confidence: 99%

Review of cranial radiotherapy-induced vasculopathy

et al. 2015

View full text Add to dashboard Cite

Cranial radiation can impact the cerebral vasculature in many ways, with a wide range of clinical manifestations. The incidence of these late effects including cerebrovascular accidents (CVAs), lacunar lesions, vascular occlusive disease including moyamoya syndrome, vascular malformations, and hemorrhage is not well known. This article reviews the preclinical findings regarding the pathophysiology of late radiation-induced vascular damage, and discusses the clinical incidence and risk factors for each type of vasculopathy. The pathophysiology is complex and dependent on the targeted blood vessels, and upregulation of pro-inflammatory and hypoxia-related genes. The risk factors for adult CVAs are similar to those for patients not exposed to cranial radiotherapy. For children, risks for late vascular complications include young age at radiotherapy, radiotherapy dose, NF1, tumor location, chemotherapy, and endocrine abnormalities. The incidence of late vascular complications of radiotherapy may be impacted by improved technology, therapeutic interventions, and appropriate follow up.

show abstract

“…Also, clinically silent lacunar lesions, which are believed to be a consequence of radiation-induced microvascular disease within the territories of branching arterioles of the major cerebral arteries, were not examined in this report. 19 Finally, we did not consider transient ischemic attacks (TIAs) or reversible ischemic neurologic deficits (RINDs) to be strokes.…”

Section: Review Of Medical Recordsmentioning

confidence: 99%

Nonperioperative strokes in children with central nervous system tumors

Bowers

Mulne

Reisch

et al. 2002

Cancer

View full text Add to dashboard Cite

BACKGROUNDNonperioperative strokes are rare yet potentially devastating events for children with central nervous system (CNS) tumors. The incidence of and risk factors for nonperioperative strokes in children with CNS tumors is unknown.METHODSThe authors performed a retrospective review of children from their institution with CNS tumors. The incidence of stroke in the nonperioperative period and the influence of patient demographic factors, coexisting genetic diseases, tumor type, and treatment modality on the subsequent occurrence of a stroke were determined.RESULTSEight hundred seven consecutive patients from the authors' institution with CNS tumors were observed for a combined 3224 nonperioperative years. Thirteen patients (1.6%) had a nonperioperative stroke, for an incidence of 4.03 strokes/1000 years of nonperioperative patient follow‐up. Eight patients were males, and the median age at diagnosis of a CNS tumor was 4.8 years (range, 0.3–18.6 years). The median duration from diagnosis of a CNS tumor until the occurrence of stroke was 2.3 years (range, 0.3–15.8 years). Among numerous potential risk factors individually examined by chi‐square analysis, only treatment with radiation therapy was associated with the subsequent development of a stroke (chi‐square, P = 0.007). By logistic regression analysis, treatment with radiation therapy and a diagnosis of an optic pathway glioma were the only statistically significant variables associated with a stroke.CONCLUSIONSStrokes are much more common among children with CNS tumors. Children treated with radiation therapy and those with optic pathway gliomas have a higher association with the occurrence of a subsequent nonperioperative stroke. Because children with optic pathway gliomas may be at particularly high risk of stroke after radiation therapy, the desired beneficial therapeutic effects of irradiation must always be weighed against its potentially adverse effects, including stroke. Cancer 2002;94:1094–101. © 2002 American Cancer Society.DOI 10.1002/cncr.10353

show abstract

Silent Lacunar Lesions Detected by Magnetic Resonance Imaging of Children With Brain Tumors: A Late Sequela of Therapy

Abstract: Lacunes may be caused by therapy-induced vasculopathy in children with brain tumors, with the most significant predictor being age less than 5 years at the time of radiotherapy.

Cited by 80 publications

References 25 publications

Recommendations for Assessing Cognitive Risks in Young Children Treated for Ependymoma for Clinical and Research Protocols: Evidence from a Systematic Literature Review

Recommendations for Assessing Cognitive Risks in Young Children Treated for Ependymoma for Clinical and Research Protocols: Evidence from a Systematic Literature Review

Review of cranial radiotherapy-induced vasculopathy

Nonperioperative strokes in children with central nervous system tumors

Contact Info

Product

Resources

About