{"id":"4308ef82-e846-47fc-946f-920fd7121aef","slug":"smart-syndrome-stroke-like-migraine-attacks-after-radiation-therapy-when-to-suspect-it","title":"SMART Syndrome (Stroke-like migraine attacks after radiation therapy): When to suspect it?","authors":["Petros Angelidis","Christian Saleh","Phillip Jaszczuk","Muhannad Seyam","Katarina Alexandra Ebner","Margret Hund-Georgiadis"],"abstract":"Background: Stroke-like migraine attacks after radiation therapy (SMART) syndrome is a benign complication of brain radiation therapy, which presents circa a decade after radiation treatment. Symptoms are stroke-like deficits, epileptic seizures, and migraine. Cranial magnetic resonance imaging is characteristic for alterations in the form of unilateral cortical hyperintensities and gyriform enhancement, most prominent in the parieto-occipital regions. Prompt diagnosis is essential to avoid unnecessary investigations (e.g., brain biopsy and angiography). Case Description: We describe a 51-year-old female patient treated initially with cranial irradiation for a left-sided occipital metastatic lung adenocarcinoma. Five years later, she presented with migraine headache, aphasia, and a right sided hemiparesis. Conclusion: The triad of migraine, seizure, and hemiparesis within the context of a prior brain radiotherapy should promptly raise the suspicion of SMART syndrome. Prompt diagnosis is essential to avoid unnecessary invasive investigations.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/4308ef82-e846-47fc-946f-920fd7121aef/featured/hero-1781561846527.png","publishDate":"2021-11-16T00:00:00.000Z","doi":"10.25259/SNI_893_2021","categories":["Neurovascular","Case Report"],"fullTextUrl":"https://surgicalneurologyint.com/api/articles/4308ef82-e846-47fc-946f-920fd7121aef/pdf"}