Incidence of vasculopathy in children with hypothalamic/chiasmatic gliomas treated with brachytherapy
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : U. Tacke & D. Karger & J. Spreer & A. Berlis & G. Nikkhah & R. Korinthenberg
- چاپ و سال / کشور: 2011
Description
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 and methods 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 and discussion 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
Childs Nerv Syst (2011) 27:961–966 DOI 10.1007/s00381-010-1370-0 Received: 21 November 2010 / Accepted: 8 December 2010 / Published online: 17 March 2011
