SMART syndrome: a late reversible complication of radiotherapy

Abstract

A 43-year-ol d female had a cerebellar pilocytic astrocy-toma operated 27 years ago. Reoperation and radiation ther-apy were employed in a recurrence 13 years ago. One week before admission, progressive drowsiness, disorientation in time and space, slurred speech and worsening of a residual right hemiparesis begun. Cerebrospinal ˜ uid (CSF) analysis and electroencephalography (EEG) were unremarkable. She improved without speci˚ c therapy.Recently recognized stroke-like migraine attacks after radiation therapy (SMART) is a syndrome which consists of prolonged, unilateral neurological symptoms that are spon-taneously reversible