Introduction

Cranial irradiation is used both prophylactically and for the treatment of brain tumors. There are various complications associated with it. The rare complication of stroke-like migraine attacks after radiation therapy (SMART) syndrome usually occurs several years after radiation therapy but is a reversible phenomenon. It usually presents with headaches, seizures, or other focal neurological deficits concerning stroke or recurrence of the underlying disease.

Objectives

We aim to present two cases of SMART syndrome highlighting the typical presentation, imaging findings, and differential diagnosis. We also conducted the literature review since the early recognition of this rare delayed onset complication is crucial, given its self-limited course and to avoid misinterpretations of the cases.

Conclusion

Our extensive review favors MRI, CT, and prolonged EEG monitoring to rule out other differentials and showed that initiation of corticosteroid therapy and antiepileptic treatment were helpful in the resolution of symptoms and prevent recurrences. Therefore, future studies should be focused on early identification and management guidelines for SMART syndrome.

中文翻译：

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放射治疗（SMART）综合征后的中风样偏头痛发作-病例系列和综述。

介绍

颅骨辐射既可用于预防也可用于治疗脑肿瘤。有各种各样的并发症。放射治疗（SMART）综合征后中风样偏头痛发作的罕见并发症通常在放射治疗后数年发生，但是可逆的现象。它通常表现出与中风或基础疾病复发有关的头痛，癫痫发作或其他局灶性神经功能缺损。

目标

我们旨在介绍两例SMART综合征，突出典型表现，影像学发现和鉴别诊断。我们还进行了文献复习，因为鉴于这种罕见的延迟发作并发症的自限过程并避免对病例的误解，因此尽早识别这种罕见的延迟发作并发症至关重要。

结论

我们的广泛审查赞成MRI，CT和长时间的EEG监测以排除其他差异，并表明开始皮质类固醇激素疗法和抗癫痫药有助于缓解症状和预防复发。因此，未来的研究应集中于SMART综合征的早期识别和治疗指南。