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SMART syndrome: a late-onset and not always reversible complication of radiotherapy
  1. Raquel Rocha1,2,
  2. Luís Ribeiro2 and
  3. Filipe Correia2
  1. 1Harvard Medical School, Boston, Massachusetts, USA
  2. 2Neurology Department, Hospital Pedro Hispano, Matosinhos, Portugal
  1. Correspondence to Dr Raquel Rocha; rmrocha84{at}


Stroke-like migraine attacks after radiation (SMART) syndrome is a rare and late complication of cerebral radiotherapy of unknown pathophysiology. It is characterised by hemicranial headache associated with persistent unilateral focal neurological signs and, occasionally, epileptic seizures. An increase in the frequency of SMART syndrome can be attributed to an increase in the survival rate of patients undergoing radiation therapy This study details the case of a 60-year-old woman with a history of small-cell lung carcinoma, who, in her late forties, was treated with prophylactic cranial irradiation. She presented at the emergency room with acute onset of global aphasia, lethargy and headache that started a few days before.

  • headache (including migraines)
  • neurooncology

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  • Contributors RR and LR writed the case report. FC review it.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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