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Research ArticleCLINICAL IMAGES
Open Access

Stroke-Like Migraine Attacks After Radiation Therapy Syndrome

Daniel April, Neil Lall and Andrew Steven
Ochsner Journal March 2020, 20 (1) 6-9; DOI: https://doi.org/10.31486/toj.19.0090
Daniel April
1Department of Radiology, Ochsner Clinic Foundation, New Orleans, LA
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Neil Lall
2Department of Radiology, Emory University School of Medicine, Atlanta, GA
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Andrew Steven
1Department of Radiology, Ochsner Clinic Foundation, New Orleans, LA
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    Figure 1.

    Magnetic resonance imaging on hospitalization day 9. Axial T1-weighted images through the level of the cerebral hemispheres before (A) and after (B) the administration of gadolinium contrast demonstrate diffuse gyral enhancement throughout much of the left cerebral hemisphere with some sparing of the frontal lobe, with corresponding mildly hyperintense signal on a T2/fluid attenuated inversion recovery image (C) and diffusion restriction on diffusion weighted imaging (D).

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    Figure 2.

    Follow-up magnetic resonance imaging 1 week later. Axial T1-weighted images through the level of the cerebral hemispheres before (A) and after (B) the administration of gadolinium contrast demonstrate few remaining foci of cortical enhancement involving the left posterior parietal and occipital lobes, with corresponding mild residual T2/fluid attenuated inversion recovery signal along the left occipital lobe (C) and persistent cortical restricted diffusion involving the left posterior parietal and occipital lobes on diffusion weighted imaging (D).

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    Figure 3.

    Magnetic resonance imaging at 5-month follow-up. Axial T1-weighted images before (A) and after (B) the administration of gadolinium contrast demonstrate minimal cortical intrinsic T1 shortening along the left posterior parietal and occipital cortex consistent with laminar necrosis but complete resolution of the postcontrast cortical enhancement. T2/fluid attenuated inversion recovery image demonstrates resolution of the posterior cerebral cortical signal abnormality but new left occipital subcortical hyperintensity, indicative of gliosis and encephalomalacia (C). Diffusion weighted imaging shows resolution of diffusion restriction (D).

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Ochsner Journal: 20 (1)
Ochsner Journal
Vol. 20, Issue 1
Mar 2020
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Stroke-Like Migraine Attacks After Radiation Therapy Syndrome
Daniel April, Neil Lall, Andrew Steven
Ochsner Journal Mar 2020, 20 (1) 6-9; DOI: 10.31486/toj.19.0090

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Stroke-Like Migraine Attacks After Radiation Therapy Syndrome
Daniel April, Neil Lall, Andrew Steven
Ochsner Journal Mar 2020, 20 (1) 6-9; DOI: 10.31486/toj.19.0090
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  • Article
    • INTRODUCTION
    • HISTORY AND CASE REPORT
    • RADIOGRAPHIC APPEARANCE AND TREATMENT
    • DISCUSSION
    • DIFFERENTIAL DIAGNOSIS
    • CONCLUSION
    • ACKNOWLEDGMENTS
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