Neuropediatrics 2006; 37(6): 364-366
DOI: 10.1055/s-2007-964903
Short Communications

Georg Thieme Verlag KG Stuttgart · New York

Moyamoya Syndrome after Cranial Irradiation for Bone Marrow Transplantation in a Patient with Acute Leukemia

N. Ishikawa1 , G. Tajima1 , N. Yofune1 , S. Nishimura1 , M. Kobayashi1
  • 1Department of Pediatrics, Hiroshima University Graduate School of Biomedical Science, Hiroshima, Japan
Further Information

Publication History

Received: July 26, 2006

Accepted after Revision: January 3, 2007

Publication Date:
14 March 2007 (online)

Abstract

It is well known that radiation-induced vasculopathy and arteritis are two of the complications of whole brain radiation therapy. Moyamoya syndromes after cranial irradiation among patients with brain tumors were previously reported. However, we could find only three cases of prophylactic cranial irradiation for hematological disorders and no case of cranial irradiation before bone marrow transplantation in patients with acute leukemia. We recently treated a boy who developed moyamoya vessels 1.5 years after cranial irradiation for bone marrow transplantation for acute leukemia. This is the first report of moyamoya syndrome after cranial irradiation for bone marrow transplantation. The mechanism and incidence of vasculopathy after cranial irradiation are unclear. It would be useful to accumulate data and reveal the etiology of moyamoya vessels formation after cranial irradiation.

References

  • 1 Kondoh T, Morishita A, Kamei M, Okamura Y, Tamaki M, Kohmura E. Moyamoya syndrome after prophylactic cranial irradiation for acute lymphocytic leukemia.  Pediatr Neurosurg. 2003;  39 264-269
  • 2 Mitchell W G, Fishman L S, Miller J H, Nelson M, Zeltzer P M, Soni D. et al . Stroke as a late sequela of cranial irradiation for childhood brain tumors.  J Child Neurol. 1991;  6 128-133
  • 3 Rajakulasingam K, Cerullo L J, Raimondi A J. Childhood moyamoya syndrome.  Child's Brain. 1979;  5 467-475
  • 4 Bitzer M, Topka H. Progressive cerebral occlusive disease after radiation therapy.  Stroke. 1995;  26 131-136
  • 5 Waber D P, Shapiro B L, Carpentieri S C, Gelber R D, Zou G, Dufresne A. et al . Excellent therapeutic efficacy and minimal late neurotoxicity in children treated with 18 Grays of cranial radiation therapy for high-risk acute lymphoblastic leukemia.  Cancer. 2001;  92 15-21
  • 6 Aoki S, Hayashi N, Abe O, Shirouzu I, Ishigame K, Okubo T. et al . Radiation-induced arteritis: thickened wall with prominent enhancement on cranial MR images-report of five cases and comparison with 18 cases of moyamoya disease.  Radiology. 2002;  223 683-688
  • 7 Tokunaga Y, Ohga S, Suita S, Matsushima T, Hara T. Moyamoya syndrome with spherocytosis: effect of splenectomy on strokes.  Pediatr Neurol. 2001;  25 75-77
  • 8 Lin H C, Chen R L, Wang P J. Paroxysmal nocturnal hemoglobinuria presenting as moyamoya syndrome.  Brain Dev. 1996;  36 157-160
  • 9 Kikuchi A, Maeda M, Hanada R, Okimoto Y, Ishimoto K, Kaneko T. et al . Moyamoya syndrome following childhood acute lymphoblastic leukemia.  Pediatr Blood Cancer. 2006;  48 268-272
  • 10 Hata M, Ogino I, Aida N, Saito K, Omura M, Kigasawa H. et al . Prophylactic cranial irradiation of acute lymphoblastic leukemia in childhood: outcome of late effects on pituitary function and growth in long-term survivors.  Int J Cancer. 2001;  96 117-124

M.D. Nobutsune Ishikawa

Department of Pediarics,
Hiroshima University Graduate School of Biomedical Science,

1-2-3 Kasumi, Minami-ku

Hiroshima

Japan 734-8551

Email: ishikan@hiroshima-u.ac.jp

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