Fact-sheet: Radiation-induced encephalopathy
Updated on 09/04/2020 at 2:24 PM
View all RADEOS cases associated with this fact-sheet
Definition
Complication of brain radiotherapy.
Isolated or associated with chemotherapy-related complications.
3 phases: acute, subacute, and late/chronic.
Clinical features
- Acute complications:
- within days to weeks following treatment,
- fatigue, nausea and vomiting, loss of appetite, cerebral edema, dermatitis.
- Subacute:
- a few weeks to 3 months,
- headaches, fatigue, irritability, fatigue, nausea, vomiting, drowsiness (more common in children),
- pseudoprogression is frequently observed during this phase.
- Late:
- > 3 months
- often severe and irreversible complications: cognitive impairment (sometimes several years later), dementia, death.
MRI
- Acute phase:
- diffuse vasogenic cerebral edema
- Subacute phase:
- pseudoprogression phase
- decreased rCBV
- increased ADC related to cell death
- Late/chronic phase:
- leukoencephalopathy
- extensive areas of demyelination extending to the ventricular walls, at the cortex-white matter junction, hypointense on T1 and hyperintense on T2,
- late cerebral atrophy
Management
Symptomatic treatment