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The delayed biological effects of radiation therapy on the brain and spine have been well characterized and they are a relevant issue to monitor in treated patients because of the differential diagnosis towards treatment failure and the potential associated neurological manifestations. Late effects include radionecrosis, leukoencephalopathy, large and small vessel involvement with steno-occlusion and hemorrhagic evolution, brain atrophy, spinal cord lesions mimicking motor neuron diseases, etc. The main late effects of radiation therapy are illustrated with neuroimaging findings and diagnostic clues in order to not miss these patterns and their etiology for the clinical management of patients. Unfortunately, most of late manifestation of radiation injury do not have a treatment and their natural history is poorly characterized.

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Long-Term Post-radiation Injury of the Central Nervous System: Neuroradiological Clues for Diagnosis

  • 章节

  • 发表日期：

    2026年

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  • Marialuisa Zedde,
  • Rosario Pascarella

摘要

The delayed biological effects of radiation therapy on the brain and spine have been well characterized and they are a relevant issue to monitor in treated patients because of the differential diagnosis towards treatment failure and the potential associated neurological manifestations. Late effects include radionecrosis, leukoencephalopathy, large and small vessel involvement with steno-occlusion and hemorrhagic evolution, brain atrophy, spinal cord lesions mimicking motor neuron diseases, etc. The main late effects of radiation therapy are illustrated with neuroimaging findings and diagnostic clues in order to not miss these patterns and their etiology for the clinical management of patients. Unfortunately, most of late manifestation of radiation injury do not have a treatment and their natural history is poorly characterized.