Uncommon radiation-induced neurological syndromes

Introduction

Cranial irradiation is used in settings ranging from definitive treatment of primary brain and head and neck cancers to palliation of metastatic disease and prophylaxis, as a single modality or in combination with surgery or systemic therapy. Common side-effect considerations include neurocognitive and inflammatory effects as well as damage to critical brain structures, which are discussed elsewhere in this text (see Chapter 24 for a discussion of radiation necrosis and Chapter 25 for neurocognitive dysfunction). Here, we provided a case-based review of rare complications of cranial irradiation. A comprehensive understanding of potential complications of radiation therapy is necessary for optimal multidisciplinary management of oncology patients. Generally, complications are related to the disease site, radiation field, radiation dose, age at time of treatment, receipt of combination therapies, and time since treatment completion.