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Diagnosis of Delayed Cerebral Radiation Necrosis Following Proton Beam Therapy
Mitchell Kaufman, MD;
Barbara E. Swartz, MD, PhD;
Mark Mandelkern, MD, PhD;
James Ropchan, PhD;
Manyee Gee, PhD;
William H. Blahd, MD
Arch Neurol. 1990;47(4):474-476.
Abstract
A 27-year-old man developed delayed cerebral radiation necrosis following proton beam therapy to an arteriovenous malformation. Neuroimaging with technetium 99m diethylenetriamine penta-acetic acid and positron emission tomographic scanning with fludeoxyglucose F 18 aided in his evaluation. Significant improvement of his neurologic deficits resulted from corticosteroid therapy. Clinical resolution was corroborated by serial computed tomographic scans demonstrating regression of the abnormality (a mass lesion). Various facets of radiation injury are discussed, including pathogenesis, risk factors, diagnosis, and therapy.
Author Affiliations
From the Department of Neurology (Drs Kaufman and Swartz) and the Nuclear Medicine Service (Drs Mandelkern, Ropchan, Gee, and Blahd), Wadsworth Veterans Administration Medical Center, Los Angeles, Calif; Reed Neurologic Research Institute (Dr Swartz) and the Department of Nuclear Medicine (Dr Blahd), UCLA Center for the Health Sciences; and the Department of Physics, University of California at Irvine (Dr Mandelkern).
Footnotes
Accepted for publication July 11, 1989.
Reprint requests to Department of Neurology W127B, Bldg 500, Wadsworth Veterans Administration Medical Center, Sawtelle and Wilshire boulevards, Los Angeles, CA 90073 (Dr Kaufman).
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