Radio-induced brain lesions

Introduction: Radiotherapy, an important tool in multimodal oncologic treatment, can cause radio-induced brain lesion development after a long period of time following irradiation. Material and method: We report 4 cases with radio-induced brain lesions, admitted into the Fourth Department of Neurosurgery, Emergency Clinical Hospital Bagdasar-Arseni, during a 4 years period of time. Results: Two patients had meningiomas and two had unruptured cavernomas. Other side effects of radiotherapy, such as diffuse brain atrophy, leukoencephalopathy, optic atrophy, panhypopituitarism were also noted. The two patients with large meningiomas underwent surgery, with good outcome. Observation was the choice for the two asymptomatic cavernomas. Panhypopituitarism needed synthetic hormonal replacement therapy. Conclusions: Radiotherapy can cause long-term complications and can induce development of new brain lesions into previous radiation area. Meningiomas and cavernomas can be radio-induced brain lesions. Meningiomas can grow to large size, requiring surgery. Unruptured asymptomatic cavernomas can be left in place and patients are followed clinical and with serial imaging. Other findings after radiotherapy are diffuse brain atrophy, leukoencephalopathy, optic atrophy and panhypopituitarism.