Delayed radiation necrosis of the brain.
Delayed radiation necrosis of the brain.
复制标题
大脑迟发性放射性坏死。
DOI：
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发表时间：
1977
影响因子：
4.1
通讯作者：
Thomas J. Stoffel
中科院分区：
文献类型：
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作者：
Albert N. Martins;James S. Johnston;James M. Henry;Thomas J. Stoffel
本文报告六例迟发性放射性脑坏死的临床表现。5例经组织学证实。症状最常见于放疗后开始9个月至2年。进行性视力损害和痴呆是常见的以下鞍周照射，而半球的迹象占主导地位的照射后的大脑。脑脊液蛋白可能升高。局灶性δ减慢通常出现在脑电图上。坏死的脑在放射性核素脑扫描上可能表现为异常摄取区，也可能表现为无血管性占位性病变。放射性坏死在计算机断层扫描中表现为脑内吸收系数降低的区域，静脉注射造影剂后常常增强。在某些病例中，该综合征可能具有足够的特征性，无需手术探查和活检。累积的经验表明，当脑肿瘤的标准剂量为5000 - 7000拉德，而每日剂量超过200拉德时，放射治疗的风险-获益比对大多数良性颅内肿瘤患者越来越不利。
The cases of six patients are presented to delineate the clinical profile of delayed radiation necrosis of the brain. In five the diagnosis was verified histologically. Symptoms most often begin 9 months to 2 years after radiotherapy. Progressive visual impairment and dementia are common following perisellar irradiation, while hemispheric signs predominate following irradiation of the cerebrum. Cerebrospinal fluid protein may be elevated. Focal delta slowing is usually present on electroencephalography. The necrotic brain may appear on radionuclide brain scan as an area of abnormal uptake and also act as an avascular space-occupying lesion. With computerized tomography, radiation necrosis appears as an intracerebral area with diminished absorption coefficient that is often enhanced with intravenous contrast medium. The syndrome may be sufficiently characteristic to eliminate the need for surgical exploration and biopsy in some cases. Cumulative experience suggests that the risk-to-benefit ratio of radiotherapy becomes increasingly unfavorable for most patients with benign intracranial neoplasms when the standard brain tumor dose of 5000 to 7000 rads is fractionated at greater than 200 rads per day.