Ischemic stroke in a patient with earlier glioma – delayed effect of irradiation?
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Neurology and Stroke Department, Independent Public Healthcare Centre, Jankowski Regional Hospitaln Przeworsk, Poland
Department of Experimental Oncology, Ludwik Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland
Anna Kozak-Sykała   

Neurology and Stroke Department, Independent Public Healthcare Centre, Jankowski Regional Hospital in Przeworsk,, 16 Szpitalna Street, 37-200, Przeworsk, Poland
J Pre Clin Clin Res. 2019;13(2):79–82
Early complications associated with glioma therapy are common and may seriously aggravate the patient’s condition. On the other hand, little is known about the late effects of glioma treatment. The case is presented of a 58-year-old woman admitted to hospital with suspected brain tumor recurrence. The patient had been diagnosed 3 years earlier with glioblastoma multiforme. On admission, the patient presented dysarthria, central paresis of nerve VII and left limb flaccid paralysis, which led to the suspicion of tumour regrowth. MR brain scans performed 1 hour after symptom onset were inconclusive. However, MR images acquired 72 hours after admission revealed a picture of fresh vascular, ischemic lesion on the right side of the posterior part of the lenticular nucleus. Physicians should be aware that the risk of brain infarct may be increased in long-term survivals with brain tumours.
This study was supported by Grant No. 3/2015 from the State Committee for Scientific Research, Warsaw, Poland.
Verdecchia A, De Angelis G, Capocaccia R. Estimation and projections of cancer prevalence from cancer registry data. Stat Med. 2002; 21: 3511–3526.
Urbańska K, Sokołowska J, Szmidt M, Sysa P. Glioblastoma multiforme – an overview. Contemp Oncol (Pozn). 2014; 18: 307–312.
Stupp R, Mason WP, van den Bent MJ, Weller M, Fisher B, Taphoorn MJ, et al. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med. 2005; 352: 987–996.
Diaz AZ, Choi M. Radiation-associated toxicities in the treatment of high-grade gliomas. Semin Oncol. 2014; 41: 532–540.
Kondziolka D, Bernstein M, Resch L, Tator CH. Brain tumours presenting with tias and strokes. Can Fam Physician. 1988; 34: 283–286.
Marras LC, Geerts WH, Perry JR. The risk of venous thromboembolism is increased throughout the course of malignant glioma: an evidencebased review. Cancer 2000; 89: 640–646.
Yaldizli O, Kastrup O, Wanke I, Maschke M. Basal ganglia infarction mimicking glioblastoma. Eur J Med Res. 2005; 10: 400–401.
Wick W, Kaufmann A. Glioblastoma: what’s ischemia got to do with it? Neurology 2006; 67: 1540–1541.
Rojas-Marcos I, Martin-Duverneuil N, Laigle-Donadey F, Taillibert S, Delattre JY. Ischemic stroke in patients with glioblastoma multiforme. J Neurol. 2005; 252: 488–489.
Obeid M, Ulane C, Rosenfeld S. Pearls & Oy-sters: Large vessel ischemic stroke secondary to glioblastoma multiforme. Neurology 2010; 74: e50–51.
Dorresteijn LD, Kappelle AC, Boogerd W, Klokman WJ, Balm AJ, Keus RB, van Leeuwen FE, Bartelink H. Increased risk of ischemic stroke after radiotherapy on the neck in patients younger than 60 years. J Clin Oncol. 2001; 20: 282–288.
Bitzer M, Topka H. Progressive cerebral occlusive disease after radiation therapy. Stroke 1995; 26: 131–136.
Erridge SC, Conkey DS, Stockton D, Strachan MW, Statham PF, Whittle IR, Grant R, Kerr GR, Gregor A. Radiotherapy for pituitary adenomas: long-term efficacy and toxicity. Radiother Oncol. 2009; 93: 597–601.
Meijer HJM, Dorresteijn LDA, Schinagl DAX, van Laarhoven HWM. Recurrent stroke after low dose whole brain radiotherapy for brain metastases of breast cancer. IJCRI. 2014; 5: 32–35.