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Radiation-Induced Cavernomas of the Brain

Rajan Jain, Patricia L. Robertson, Dheeraj Gandhi, Sachin K. Gujar, Karin M. Muraszko and Stephen Gebarski
American Journal of Neuroradiology May 2005, 26 (5) 1158-1162;
Rajan Jain
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Patricia L. Robertson
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Dheeraj Gandhi
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Sachin K. Gujar
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Karin M. Muraszko
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Stephen Gebarski
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    Fig 1.

    Case 1.

    A, Axial T2-weighted MR image obtained 12 years after craniospinal radiation therapy at 3 years of age for a posterior fossa medulloblastoma showing no lesion in the left temporal lobe/temporal horn.

    B, Axial T1-weighted and, C, fluid-attenuated inversion recovery (FLAIR) MR images obtained 15 years after the radiation therapy, showing a lobulated area of mixed signal intensity with peripheral hypointense rim (white arrow) in left medial temporal lobe/temporal horn, typical “popcorn” MR appearance of a cavernous angioma.

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    Fig 2.

    Case 2.

    A, Axial T2- and, B, T1-weighted MR images obtained 3 years after involved field radiation therapy at 3 years of age for a posterior fossa ependymoma showing a large hemorrhagic, lobulated lesion of mixed signal intensity (white arrow) in left cerebellar hemisphere and vermis. Two more small cavernomas (black arrowheads) are seen in the right cerebellum. Postoperative changes (black arrow) are noted in the right cerebellum.

    C, Axial T2‐weighted MR image shows an area of blooming due to another small cavernoma (black arrow) in the right temporo-occipital region.

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    Fig 3.

    Case 4.

    A, Axial T2-weighted MR image obtained 6 years after craniospinal radiation therapy at age 13 years for a suprasellar germinoma showing no lesion in right frontoparietal region.

    B, Axial T2-weighted and, C, FLAIR MR images obtained 8 years after the radiation therapy showing interval appearance a round lesion of mixed signal intensity with a fluid-fluid level and peripheral hypointense rim (black arrow) in right frontoparietal region.

Tables

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    Case No.Age*/SexPrimary CNS Neoplasm Or DiseaseAge at RT (years)RT and DoseLatency Interval (years)Clinical PresentationLocation of CM’sNumber of CM’sTreatment of CM’sAssociated Findings
    118/FPosterior fossaMedulloblastoma3Craniospinal RT54 Gy (T)36 Gy (CS)15IncidentalLt temporal lobe/Intraventricular1ObservationMeningioma Scalp DFS Panhypopitutarism
    Rt cerebellum1Observation
    26/MPosterior fossaEpendymoma3Involved field RT50.4 Gy3Incidental (Subsequent asymptomatic Hemorrhage)Lt cerebellumRt cerebellumRt temporal lobe121SurgeryObservationObservationTH & GH Deficiency
    334/MPosterior fossaMedulloblastoma3Craniospinal RT54 Gy (T) 36 Gy (CS)31IncidentalLt frontal lobe1ObservationMeningioma
    421/MSupra-sellarGerminoma13Craniospinal RT50.4 Gy (T)36 Gy (CS)8Incidental (Subsequent asymptomatic hemorrhage)Rt fronto-parietal lobe1Surgery-
    557/FCushing’s Disease16Cobalt RT Unknown dose41IncidentalRt frontal lobe1ObservationPanhypopitutarism
    • Note.—Age* indicates Age at the time of diagnosis of cavernomas; RT, Radiation therapy; T, Total Dose; CS, Craniospinal Dose; CM’s, cavernous malformations; DFS, Dermatofibrosarcoma; TH, Thyroid hormones; GH, Growth hormone.

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American Journal of Neuroradiology: 26 (5)
American Journal of Neuroradiology
Vol. 26, Issue 5
1 May 2005
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Cite this article
Rajan Jain, Patricia L. Robertson, Dheeraj Gandhi, Sachin K. Gujar, Karin M. Muraszko, Stephen Gebarski
Radiation-Induced Cavernomas of the Brain
American Journal of Neuroradiology May 2005, 26 (5) 1158-1162;

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Radiation-Induced Cavernomas of the Brain
Rajan Jain, Patricia L. Robertson, Dheeraj Gandhi, Sachin K. Gujar, Karin M. Muraszko, Stephen Gebarski
American Journal of Neuroradiology May 2005, 26 (5) 1158-1162;
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