QOS-29STROKES AND VASCULAR CHANGES IN IRRADIATED CHILDHOOD BRAIN TUMOR SURVIVORS

Abstract

BACKGROUND: As the first survivors of malignant childhood brain tumors are aging, the very long-term sequelae appear. Ischemic strokes and hemorragia are one of the most devastating late-effects causing disability and mortality. METHODS: The study included a total of 74 adults (mean age 28,4 years, range 16,2 -43,8 years) treated for childhood brain tumour in the fiveUniversityHospitals in Finland during 1970–2008. All had received CNS irradiation as part of their treatment. Mean follow-up time since cessation of therapy was 19,0 years (range 5,0–33,0). 127 patients were eligible for the study, but 54 declined to participate or could not be contacted. Ischemic strokes and hemorrhagia were studied from the patient files. Brain MRI was performed to identify ischemic or post hemorrhagic lesions, and MRA was used to analyse circulus Willisi and brain vessels. RESULTS: Of the patients, 17/74 (23,0%) had any vascular CNS complication. 5/74 (6,8 %) had had ischemic stroke and 7/74 (9,5 %) transient ischemic attack during the follow-up. Previous hemorrhagia was found in 6/74 (8,1 %) patients. One patient had arterial stenosis in brainMRA, one had teleangiectasia in temporal lobe and six (8,3 %) had cavernoma or cavernomas. All the patients with vascular changes were asymptomatic for the changes at the time of the study. CONCLUSIONS: Vascular changes and ischemic strokes are common in irradiated survivors of childhood brain tumors.