The Risks associated with treating S.M.A.R.T syndrome using Blood Thinners for pediatric patients who received Cranial/Spinal irradiation. A case study.

Abstract

S.M.A.R.T Syndrome (Stroke-like Migraine Attacks after Radiation Therapy) is a late complication after cranial radiation, along with seizures, and white matter lesions. SMART syndrome is diagnosed in patients who previously received craniospinal irradiation presenting with unexplained headaches, seizures and hemiparesis (weakness on one side of the body which is revirsable) few years after irradiation. M.R.I (Magnetic resonance imaging) is usually helpful in diagnosis. In such cases, blood thinners such as Aspirin are prescribed as a medication to decrease the potential risks associated with radiation induced brain infarction/necrosis to avoid further deterioration. However blood thinners such as Aspirin have been linked to sudden hematoma occurring in the brain. The case reported was observed in a patient with vasculopathy/S.M.A.R.T syndrome who previously underwent high dose chemotherapy, and craniospinal irradiation (CSI) and was prescribed baby aspirin which may have contributed to epidural hematoma/hemorrhage.