Autopsy report of a late delayed radiation injury after a period of 45 years

Abstract

For delayed radiation injury, image analysis has considerably advanced, but neuropathological findings are still required to establish diagnosis. A patient who had received radiation therapy for pineal germinoma at age 14 developed neurological and psychiatric abnormalities after 15 years as a late delayed radiation injury. Autopsy at age 59 revealed diffuse changes in the white matter consisting in order of severity of myelin pallor, demyelination, and necrosis which were characterized by a lack of glial reaction. The cerebral cortex was relatively well preserved. As delayed radiation injuries, hyalinous changes in the vascular wall, angiomatous lesions and, fresh and old petechial hemorrhages were found. Moreover, vascular changes associated with arteriosclerosis were also present. Furthermore, a focal glial nodule was detected which was considered to be a new radiation‐induced neoplasia. These findings suggest that late delayed radiation injury may slowly develop over 30 years and may involve damage to neuroglial stem cell compensation. It is also evident that arteriosclerotic changes and newly induced neoplasia may develop in delayed radiation injury cases.

Reduction of pTau and APP Levels in Mammalian Brain After Low-Dose Radiation

“…4 weeks) could greatly help in elucidating some of the earlier molecular events associated with different types of late neurological sequelae. These sequelae, among others, include neuroin ammatory and demyelination phenomena, which are often observed during the later phases of the post-radiation natural progression in those subjects exposed to brain radiation for either medical or non-medical reasons 33,34 . Moreover, a better understanding of the post-radiation molecular and neuropathological changes in normal large mammalian brain tissue could also considerably contribute to identifying more effective prophylactic options that could be used in either clinical or nuclear environmental contamination/attack settings.…”

Cerebral Autoregulation and Neurovascular Coupling after Craniospinal Irradiation in Long-Term Survivors of Malignant Pediatric Brain Tumors of the Posterior Fossa

“…[8][9][10][11] An autopsy report of a late delayed radiation brain injury showed atherosclerotic changes, as well as hyalinous changes in the vascular wall, angiomatous lesions, and old petechial hemorrhages. 12 Physiologically, different mechanisms regulate cerebral blood flow. Cerebral autoregulation is an important mechanism to keep cerebral blood flow stable despite changes in cerebral perfusion pressure.…”