Abstract
We have diagnosed a case of recurrent optic gloma associated with moyamoya vascularity 8 years after postoperative irradiation.
A 12-year-old girl, who was initially admitted to our hosptial at the age of 4 years with a diagnosis of suprasellar tumor with obstructive hydrocephalus and treated by partial removal of the tumor followed by postoperative irradiation with a tumor dose of 49.5 Gy, developed headache associated with enlargement of the tumor. Left carotid angiography revealed stenosis of the terminal portion of the internal carotid artery, Ml portion of the middle cerebral artery, and Al portion of he anterior cerebral artery with ethmoidal and vault moyamoya. Right side showed stenosis of the M1 portion of the middle cerebral artery with ethmoidal moyamoya.
Possible causes of the occlusive arteriopathy in this case were compression by the supraellar tumor or secondary arterial changes due to radiotherapy of the tumor. We believe that the latter was the more possible cause becaue the suprasellar tumor was a benign glioma and smaller in size on this admission compared with preoperative tumor size.
The clinical features of radiation-induced intracranial occlusive vascular disease were analyzed for our case and for other reported in the literature.
