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<p>Stroke-like migraine attacks after radiation therapy (SMART) syndrome is a rare and relatively recently described phenomenon occurring as a late complication of high-dose cranial irradiation. More common complications from cranial irradiation such as neoplasms and vasculopathy present with a more identifiable imaging picture unlike what pertains to SMART syndrome. We herein present the case of a woman in her 6th decade of life, who had excision of a malignant brain tumour with adjuvant cranial irradiation 20&#xa0;years before presentation. She presented with recurrent right occipital headaches without localizing signs. Her brain MRI showed features suggestive of SMART syndrome. Almost 10&#xa0;years before this current presentation, she had been diagnosed with a nonspecific encephalitis-like condition. Though the impression of SMART syndrome was eventually made, it could have posed a diagnostic dilemma due to its rarity. Limited knowledge about it may lead to misdiagnosis or harmful interventions in attempting to exclude more sinister pathologies.</p>

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A Case of Recurrent SMART Syndrome—Revisiting the Clinicoradiological Picture and Review of the Literature: Case Report

  • 期刊论文

  • 发表日期：

    2025年5月19日

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  • Hafisatu Gbadamosi,
  • Jia Xu Lim,
  • Robert Chun Chen,
  • Sarat Kumar Sanamandra

摘要

Stroke-like migraine attacks after radiation therapy (SMART) syndrome is a rare and relatively recently described phenomenon occurring as a late complication of high-dose cranial irradiation. More common complications from cranial irradiation such as neoplasms and vasculopathy present with a more identifiable imaging picture unlike what pertains to SMART syndrome. We herein present the case of a woman in her 6th decade of life, who had excision of a malignant brain tumour with adjuvant cranial irradiation 20 years before presentation. She presented with recurrent right occipital headaches without localizing signs. Her brain MRI showed features suggestive of SMART syndrome. Almost 10 years before this current presentation, she had been diagnosed with a nonspecific encephalitis-like condition. Though the impression of SMART syndrome was eventually made, it could have posed a diagnostic dilemma due to its rarity. Limited knowledge about it may lead to misdiagnosis or harmful interventions in attempting to exclude more sinister pathologies.