Incidence of vasculopathy in children with hypothalamic/chiasmatic gliomas treated with brachytherapy.
Childs Nerv Syst
; 27(6): 961-6, 2011 Jun.
Article
em En
| MEDLINE
| ID: mdl-21416133
ABSTRACT
INTRODUCTION:
External brain irradiation in children can cause cognitive decline, endocrine dysfunctions and second malignancies. A rare complication is cerebral vasculopathy, which occurs most often in patients with neurofibromatosis type 1. Interstitial radiotherapy using transient Iodine-125 implants is a radiotherapy option, called brachytherapy, offering excellent survival rates, but little is known on treatment-related morbidity, especially long time vascular changes. PATIENTS ANDMETHODS:
Thirteen children with low-grade hypothalamic gliomas, four of them with neurofibromatosis type 1, were diagnosed and treated at the University Hospital Freiburg, Germany. They belong to a larger group of 44 children with suprasellar low-grade gliomas, treated with transient Iodine-125 seeds and include those who attended all routine follow-up examinations in Freiburg. After written informed consent from the parents or caregivers all patients underwent magnetic resonance imaging with angiographic techniques in 2001, 3 to 13 years after treatment. RESULTS ANDDISCUSSION:
Six out of 13 revealed cerebral vasculopathies, only one of them revealed symptoms of intermittent cerebral ischemia. Neurofibromatosis type 1 was present in one affected patient. The aetiology of the cerebral vascular changes is not fully understood so far. Tumour encasement, surgical damage and brachytherapy may contribute as a single risk factor or in combination. To get more information, we recommend MRA for artery vasculopathy at follow-up in all patients with suprasellar brain tumours irrespectively to their former treatment or presence of cerebrovascular symptoms.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Quiasma Óptico
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Lesões por Radiação
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Braquiterapia
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Transtornos Cerebrovasculares
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Glioma
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Neoplasias Hipotalâmicas
Idioma:
En
Ano de publicação:
2011
Tipo de documento:
Article