Advances in Clinical and Experimental Medicine

Adv Clin Exp Med
Impact Factor (IF) – 1.227
Index Copernicus (ICV 2018) – 157.72
MNiSW – 40
Average rejection rate – 84.38%
ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

Download PDF

Advances in Clinical and Experimental Medicine

2016, vol. 25, nr 4, July-August, p. 789–797

doi: 10.17219/acem/37716

Publication type: review article

Language: English

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

Creative Commons BY-NC-ND 3.0 Open Access

Brain MRI Findings in Neurological Complications of Cancer Treatment

Astra Cabaj1,A,D, Monika Bekiesińska-Figatowska1,A,B,C,E,F, Agnieszka Duczkowska1,B,C, Marek Duczkowski1,B,C

1 Department of Diagnostic Imaging, Institute of Mother and Child, Warszawa, Poland

Abstract

The amount of people living with cancer is increasing; they live longer and have thus a higher risk of developing neurological complications. Magnetic resonance as a diagnostic procedure of choice in detecting the reasons of neurological/psychiatric symptoms in oncological patients is nowadays relatively easily accessible. Early diagnosis established by radiologists familiar with neurological entities that may follow cancer treatment allow clinicians to provide proper treatment, even if the diagnosis seems unbelievable. The review of MR images of acute and chronic neurological complications of cancer treatment from the authors’ own archive is the focus of this report. Neurological complications of cancer can be metastatic and non-metastatic; the first cannot be considered as a treatment complication, the latter can be chemoor radiotherapy-induced, acute, chronic and delayed. In our material we dealt with complications with dramatic course (stroke, PRES, acute leukoencephalopathy, Wernicke’s encephalopathy) and with cases with milder and/or longer course (neuro-infections, chronic leukoencephalopathy, telangiectasias and/or cavernous hemangiomas, second tumors: glioma and meningioma after irradiation). The central nervous system is very susceptible to complications of systemic cancer and its treatment. Even though the first thought of clinicians and radiologists after a patient’s first neurological/psychiatric symptoms appears concerns the metastatic spread of the disease, they need to have an understanding that there are a number of other causes of such symptoms. The knowledge of entities which can be expected and diagnostic experience prevent clinicians from making wrong diagnosis.

Key words

complications, brain, cancer therapy, magnetic resonance imaging (MRI)

References (20)

  1. Hwang TL, Close TP, Grego JM, Brannon WL, Gonzales F: Predilection of brain metastasis in gray and white matter junction and vascular border zones. Cancer 1996, 77, 1551–1555.
  2. DeAngelis LM, Posner JB: Neurologic complications. In: Holland-Frei Cancer Medicine. Eds.: Kufe DW, Pollock RE, Weichselbaum RR, Bast RC Jr, Gansler TS, Holland JF, Frei E III. BC Decker, Hamilton (ON) 2003, 6th ed., chapter 146.
  3. Soussain C, Ricard D, Fike JR, Mazeron JJ, Psimaras D, Delattre JY: CNS complications of radiotherapy and chemotherapy. Lancet 2009, 374, 1639–1651.
  4. Crossen JR, Garwood D, Glastein E, Neuwelt EA: Neurobehavioral sequelae of cranial irradiation in adults: a review of radiation-induced encephalopathy. J Clin Oncol 1994, 12, 627–642.
  5. Wassenberg MW, Bromberg JE, Witkamp TD, Terhaard CH, Taphooprn MJ: White matter lesions and encephalopathy in patients treated for primary central nervous system lymphoma. J Neurooncol 2001, 52, 73–80.
  6. Kleinschmidt-Demasters BK, Kang JS, Lillehei KO: The burden of radiation-induced central nervous system tumors: a single institution’s experience. J Neuropathol Exp Neurol 2006, 65, 204–216.
  7. Amirjamshidi A, Abbassioun K: Radiation-induced tumors of the central nervous system occurring in childhood and adolescence. Four unusual lesions in three patients and a review of the literature. Childs Nerv Syst 2000, 16, 390–397.
  8. Nishio S, Morioka T, Inamura T, Takeshita I, Fukui M, Sasaki M, Nakamura K, Wakisaka S: Radiation-induced brain tumours: Potential late complications of radiation therapy for brain tumours. Acta Neurochir (Wien) 1998, 140, 763–770.
  9. Larson JJ, Ball WS, Bove KE, Crone KR, Tew JM Jr: Formation of intracerebral cavernous malformations after brain radiation treatment for central nervous system neoplasia in children. J Neurosurg 1998, 88, 51–56.
  10. Sioka C, Kyritsis AP: Central and peripheral nervous system toxicity of common chemotherapeutic agents. Cancer Chemother Pharmacol 2009, 63, 761–767.
  11. De Laat P, Te Winkel ML, Devos AS, Catsman-Berrevoets CE, Pieters R, van den Heuvel-Eibrink MM: Posterior reversible encephalopathy syndrome in childhood cancer. Ann Oncol 2011, 22, 472–478.
  12. Lim YJ, Kim HJ, Lee YJ, Seol IJ, Lee YH: Clinical features of encephalopathy in children with cancer requiring cranial magnetic resonance imaging. Pediatr Neurol 2011, 44, 433–438.
  13. Paul BS, Singh G, Bansal R, Paul G: Diffusion-weighted MR imaging of 5-fluorouracil and oxaliplatin-induced leukoencephalopathy. J Postgrad Med 2013, 59, 135–137.
  14. Navi BB, Kawaguchi K, Hriljac I, Lavi E, De Angelis LM, Jamieson DG: Multifocal stroke from tumor emboli. Arch Neurol 2009, 66, 1174–1175.
  15. Rogers LR: Management of stroke in cancer. Curr Oncol Rep 2008, 10, 72–77.
  16. Singh G, Rees JH, Sander JW: Seizures and epilepsy in oncological practice: Causes, course, mechanisms and treatment. J Neurol Neurosurg Psychiatry 2007, 78, 342–349.
  17. Pereira DB, Pereira ML, Gasparetto EL: Nonalcoholic wernicke encephalopathy with extensive cortical involvement: Cortical laminar necrosis and hemorrhage demonstrated with susceptibility-weighted MR phase images. Am J Neuroradiol 2011, 32, 37–38.
  18. Dalmau J, Gultekin HS, Posner JB: Paraneoplastic neurologic syndromes: Pathogenesis and physiopathology. Brain Pathology 1999, 9, 275–284.
  19. Kannoth S: Paraneoplastic neurologic syndrome: A practical approach. Ann Indian Acad Neurol 2012, 15, 6–12.
  20. Flanagan EP, McKeon A, Lennon VA, Kearns J, Weinshenker BG, Krecke KN, Matiello M, Keegan BM, Mokri B, Aksamit AJ, Pittock SJ: Paraneoplastic isolated myelopathy: clinical course and neuroimaging clues. Neurology 2011, 76, 2089–2095.