Related Experiment Video
Updated: Apr 27, 2026
09:14
Pre-Chiasmatic, Single Injection of Autologous Blood to Induce Experimental Subarachnoid Hemorrhage in a Rat Model
Published on: June 18, 2021
2.3K
Cerebral hypoperfusion secondary to radiation arteritis presenting with recurrent syncope
Khalid Bashar1, Seamus McHugh2, Paul Burke2
1Department of Vascular Surgery, Limerick University Hospital, Dublin, Ireland.
BMJ Case Reports
|June 25, 2014
Summary
Radiation arteritis can cause carotid artery stenosis, leading to cerebral hypoperfusion and syncope. Surgical bypass successfully resolved symptoms in a patient with a history of radiation therapy.
Area of Science:
- Vascular Surgery
- Neurology
- Oncology
Background:
- Radiation arteritis is a known complication of head and neck radiotherapy.
- Extracranial carotid artery stenosis can lead to cerebrovascular events.
- Cerebral hypoperfusion is a potential cause of syncope.
Observation:
- A 61-year-old man presented with recurrent syncope despite negative cardiac workup.
- He had a history of cervical radiation for tonsillar cancer 15 years prior.
- Imaging revealed bilateral carotid occlusive disease and left vertebral artery occlusion.
Findings:
- The patient was diagnosed with cerebral hypoperfusion secondary to severe extracranial carotid stenosis.
- Single-photon emission computed tomography (SPECT) confirmed reduced cerebral blood flow.
- A left subclavian to carotid bypass was performed.
Implications:
- This case highlights radiation arteritis as a cause of extracranial carotid stenosis and cerebral hypoperfusion.
- Surgical revascularization can effectively treat symptoms of cerebral hypoperfusion in select patients.
- Early recognition and intervention are crucial for managing radiation-induced vascular complications.
Related Concept Videos
01:22Cerebral Edema ll: Pathophysiology
14
Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this...
14
01:26Transient Ischemic Attack l: Introduction
14
A transient ischemic attack (TIA) is a brief episode of neurological dysfunction caused by a temporary, focal reduction in cerebral blood flow. Although symptoms resemble those of an ischemic stroke, the interruption in perfusion is short-lived and does not cause permanent infarction. TIAs are clinically important because they often serve as early warning events for future stroke.Mechanisms of Transient Cerebral IschemiaTransient cerebral ischemia may arise through several mechanisms. One...
14
01:21Cytotoxic Edema: Pathophysiology
19
Cytotoxic edema is a form of cerebral edema characterized by intracellular swelling of neurons, astrocytes, and other glial cells. It develops when the mechanisms responsible for maintaining ionic gradients across the cell membrane become impaired. Under normal physiological conditions, the sodium–potassium ATPase actively transports sodium ions out of the cell and potassium ions into the cell, preserving osmotic balance and enabling electrical signaling. This pump requires a continuous...
19
01:29Hemorrhagic Stroke ll: Pathophysiology
16
A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
16
01:17Hemorrhagic Stroke l: Introduction
18
A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...
18
01:15Ischemic Stroke ll: Pathophysiology
44
An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...
44