Abstract Details

Title Latent Radiation-Induced Cerebral Vasculopathy

Topic Neuro-oncology

Presentation(s) P3 - Poster Session 3 (5:30 PM-6:30 PM)

Poster/Presentation
Number 7-006

Objective Case Report

Background We present the case of 22-year-old man who presented with latent radiation induced cerebral vasculopathy. The patient presented 13 years after treatment of a childhood medulloblastoma at age 9 years, which was treated with a subtotal resection, chemotherapy (Vincrinstine, Carboplatin, Etopsoide) and cranio-spinal adjuvant radiotherapy. His initial presentation was striking however improved with a prolonged course of steroid therapy and intensive physical, speech and occupational therapy.

Design/Methods N/a

Results N/a

Conclusions Medulloblastoma accounts for approx. 18% of paediatric CNS tumours, and of these the most common site is the midline cerebellar vermis. As advances in treatment modalities for such paediatric cancers continue, it is important to consider potential long-term consequences such as vascular complications of cranial radiation which may be present in later life. Some studies have examined these long-term effects, however to our knowledge no prior cases similar to ours have been reported.
In the context of our patient, residual cerebrovascular risk is clearly an implicating factor in his presentation. The clinical response to corticosteroid therapy was a surprising event and likely attributed to anti-inflammatory action reducing the burden of vasogenic oedema around the micro-haemorrhage sites.
Although data are limited with respect to the long-term outcomes of therapeutic radiotherapy in childhood, his case highlights the absence and need for a clear consensus in relation to treatment and side-effects. Additionally, consideration for secondary prevention measures against cerebrovascular events is warranted. The risk of cerebrovascular complications following brain irradiation has been robustly demonstrated in numerous studies, however the exact mechanisms remain poorly defined. Elucidation of these mechanisms and their vascular effects could enable cerebrovascular protective strategies and ultimately better patient outcomes. Our case report highlights the need for a clearer understanding of the long-term impact of brain irradiation upon survivors of childhood cancers.

Authors/Disclosures
PRESENTER	No disclosure on file
Eoghan P. Deasy, MBBS (Cork University Hospital Neurology Department)	No disclosure on file
	No disclosure on file
Bernadette Monaghan, MD	No disclosure on file
	No disclosure on file
	No disclosure on file
Daniel Costello, MD	Dr. Costello has nothing to disclose.

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