Progressive white matter destruction following irradiation of an extracranial neoplasm

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Abstract
Although numerous “cures” have been reported following surgical extirpation of symptomatic foci of cerebral radiation necrosis, delayed progressive white matter destruction and neurological deterioration may occur in some patients who survive for prolonged periods after operation. The postoperative appearance on CT scans of hypodensity within heavily irradiated white matter structures at a distance from the initial radionecrotic focus or operative site suggests continuing radiation‐induced tissue injury and a poor prognosis. Anticipated survival as well as administered radiation dose must be taken into account when “safe” radiation thresholds are calculated.