Stroke-Like Migraine Attacks After Radiation Therapy (SMART): Um Caso Clínico

Autores

DOI:

https://doi.org/10.24950/rspmi/CC/20/19/4/2019

Palavras-chave:

Acidente Vascular Cerebral/etiologia, Perturbações de Enxaqueca/etiologia, Radioterapia/efeitos adversos

Resumo

A síndrome stroke-like migraine attacks after radiation therapy (SMART) é uma condição extremamente rara que consiste
no aparecimento de sinais e sintomas neurológicos complexos
ou estados confusionais, em doentes submetidos a radioterapia
cerebral prévia. Encontram-se alterações características na ressonância magnética cerebral que normalizam com a resolução
dos sintomas. O presente caso clínico descreve uma doente de
64 anos com antecedentes de radioterapia cerebral e aparecimento de hemiparesia direita de novo, confusão e depressão
do estado de consciência, com alterações na ressonância magnética cerebral compatíveis com síndrome SMART. Os autores
pretendem alertar para a existência desta síndrome e para o seu
eventual subdiagnóstico.

Downloads

Não há dados estatísticos.

Referências

Shuper A, Packer RJ, Vezina LG, Nicholson HS, Lafond D. ´Complicated migraine-like episodes´ in children following cranial irradiation and chemotherapy. Neurology. 1995; 45: 1837-40.

Bompaire F, Zinchenko L, Lahutte M, Mokhtari K, Psimaras D, Gaultier C, et al. SMART syndrome: Classic transient symptoms leading to an unusual unfavorable outcome. Rev Neurol (Paris). 2017; 173: 67-73 . doi: 10.1016/j.neurol.2016.09.014.

Black DF, Morris JM, Lindell EP, Krecke KN, Worrell GA, Bartleson JD, et al. Stroke-like migraine attacks after radiation therapy (SMART) syndrome is not always completely reversible: a case series. AJNR Am J Neuroradiol. 2013; 34: 2298-303. doi: 10.3174/ajnr.A3602.

Goldfinch AI, Kleinig TJ. Stroke-like migraine attacks after radiation therapy syndrome: a case report and literature review. Radiol Case Rep. 2017; 12: 610-4. doi: 10.1177/1971400917690009.

Armstrong AE, Gillan E, DiMario FJ, Jr. SMART syndrome (stroke-like migraine attacks after radiation therapy) in adult and pediatric patients. J Child Neurol. 2014; 29: 336-41, doi: 10.1177/0883073812474843.

Zheng Q, Yang L, Tan LM, Qin LX, Wang CY, Zhang HN. Stroke-like Migraine Attacks after Radiation Therapy Syndrome. Chin Med J. 2015; 128: 2097-101.

Truntzer P, Monjour A, Gaultier C, Ahle G, Guillerme F, Boutenbat G, et al. SMART Syndrome : a propos d'un cas d'une complication rare apres radiotherapie cerebrale et revue de la litterature. Cancer Radiother. 2012; 16: 295-301.

Kerklaan JP, Lycklama á Nijeholt GJ, Wiggenraad RG, Berghuis B, Postma TJ, Taphoorn MJ. SMART syndrome: a late reversible complication after radiation therapy for brain tumours. J Neurol. 2011; 258: 1098-104 .doi: 10.1007/s00415-010-5892-x.

Gomez-Cibeira E, Calleja-Castano P, Gonzalez de la Aleja J, Sierra-Hidalgo F, Ruiz Morales J, Salvador-Alvarez E, et al. Brain Magnetic Resonance Spectroscopy Findings in the Stroke-like Migraine Attacks after Radiation Therapy (SMART) syndrome. J Neuroimaging. 2015; 25: 1056-8.doi: 10.1111/jon.12227.

Singh AK, Tantiwongkosi B, Moise AM, Altmeyer WB. Stroke-like migraine attacks after radiation therapy syndrome: case report and review of the literature. Neuroradiol J. 2017; 30: 568-73, doi: 10.1177/1971400917690009.

Tomek M, Bhavsar SV, Patry D, Hanson A. The syndrome of stroke-like migraine attacks after radiation therapy associated with prolonged unresponsiveness in an adult patient. Neurologist. 2015; 19: 49-52, doi: 10.1097/NRL.0000000000000003.

Ramanathan RS, Sreedher G, Malhotra K, Guduru Z, Agarwal D, Flaherty M, et al. Unusual case of recurrent SMART (stroke-like migraine attacks after radiation therapy) syndrome. Ann Indian Acad Neurol. 2016; 19: 399- 401, doi: 10.1097/RLU.0b013e3181e4db6f.

Farid K, Meissner WG, Samier-Foubert A, Barret O, Menegon P, Rouanet F, et al. Normal cerebrovascular reactivity in Stroke-like Migraine Attacks after Radiation Therapy syndrome. Clin Nucl Med. 2010; 35: 583-5.

Dalkara T, Zervas NT, Moskowitz MA. From spreading depression to the trigeminovascular system. Neurol Sci. 2006; 27: S86–S90.

Maloney PR, Rabinstein AA, Daniels DJ, Link MJ. Surgically induced SMART syndrome: case report and review of the literature.World Neurosurg. 2014; 82: 240 e247-12, doi: 10.1016/j.wneu.2013.01.028.

Downloads

Publicado

07-02-2022

Como Citar

1.
Cruz M, Barros R, Mário Roriz J, Martins J, H. Carneiro A. Stroke-Like Migraine Attacks After Radiation Therapy (SMART): Um Caso Clínico. RPMI [Internet]. 7 de Fevereiro de 2022 [citado 5 de Novembro de 2024];26(4):308-11. Disponível em: https://revista.spmi.pt/index.php/rpmi/article/view/332

Edição

Secção

Casos Clínicos

Artigos mais lidos do(s) mesmo(s) autor(es)

1 2 > >>