SMART syndrome: two cases highlighting a complex and rare complication of brain irradiation

Hanne Blakstad; Christine Wohlleben; Cathrine Saxhaug; Petter Brandal

doi:10.1136/bcr-2022-249599

SMART syndrome: two cases highlighting a complex and rare complication of brain irradiation

BMJ Case Rep. 2022 Sep 27;15(9):e249599. doi: 10.1136/bcr-2022-249599.

Authors

Hanne Blakstad^{1

2}, Christine Wohlleben³, Cathrine Saxhaug⁴, Petter Brandal^{5

6}

Affiliations

¹ Department of Oncology, Oslo University Hospital, Oslo, Norway hanbla@ous-hf.no.
² Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
³ Department of Neurology, Akershus University Hospital, Lorenskog, Norway.
⁴ Department of Radiology, Oslo University Hospital, Oslo, Norway.
⁵ Department of Oncology, Oslo University Hospital, Oslo, Norway.
⁶ Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo, Norway.

PMID: 36167430
PMCID: PMC9516215 (available on 2024-09-27)
DOI: 10.1136/bcr-2022-249599

Abstract

Stroke-like migraine attacks after radiation therapy (SMART) syndrome is a rare complication of radiotherapy with complex neurological impairment. Patients present with neurological symptoms and signs such as migraine, hemianopsia, hemiplegia, aphasia and/or seizures-without recurrence of neoplastic disease. In this report, we describe SMART syndrome in two adult patients 4 and 14 years following brain irradiation, respectively.

Keywords: CNS cancer; neuroimaging; neurooncology; radiotherapy.

Publication types

Case Reports

MeSH terms

Adult
Brain / diagnostic imaging
Humans
Migraine Disorders* / diagnosis
Radiation Injuries* / diagnosis
Seizures / complications
Stroke* / diagnosis