SMART syndrome: Classic transient symptoms leading to an unusual unfavorable outcome

SMART – Not Always Only “Stroke‐Like”

“…In general, it is regarded as a reversible condition . However, there may be recurrence of symptoms and, as our case illustrates, there may also be ischemic stroke related to SMART and the clinical course is not necessarily benign.…”

Stroke-like Migraine Attacks after Radiation Therapy (SMART) Syndrome Followed by Cerebral Infarction

“…This rare syndrome generally develops several months or years after treatment, with the patient developing severe headache alongside various cortical dysfunctions lasting days or weeks ( 3 ). The neurological symptoms are usually reversible; however, recurrent or progressive cases have recently been reported ( 4 ). The radiological hallmark for the diagnosis of SMART syndrome is the characteristic finding of, is cortical gadolinium enhancement in a single hemisphere ( 1 ); cerebral hyperperfusion has also been reported in several cases ( 5 ).…”

Stroke-Like Migraine Attacks After Radiation Therapy (SMART): Um Caso Clínico

“…1 Como o nome indica, ocorre em doentes submetidos a irradiação cerebral para tratamento neoplásico anos antes. 2 Dada a maior prevalência de doentes sobreviventes a neoplasias, cada vez mais se tem assistido a um aumento do número de referências na literatura a esta síndrome.…”

“…6,12 Em alguns casos, os achados histológicos mostraram uma proliferação vascular, associada a infiltrados celulares perivasculares e gliose. 2,11 Alguns autores defendem que estas alterações na barreira hemato-encefálica resultariam em edema cortical, 8 enquanto outros parecem contrariar esta hipótese. 13 Outra hipótese considerada é a de disfunção neuronal, secundária ao impacto da radiação sobre o sistema trigeminovascular.…”