A 50-year-old male patient with a history of surgery and whole-brain radiation therapy 20 years ago to treat a metastatic melanoma presented with migraine-like headache, seizures, and lowered level of consciousness. MRI revealed cortical lesions with edema, restricted diffusion, gyriform enhancement, and elevated perfusion on the left temporo-occipital region (Fig. 1). Patient was treated with analgesics and anticonvulsant. After 6 months, clinical and imaging manifestations showed improvement (Fig. 2). SMART (stroke-like migraine attacks after radiation therapy) is a benign late complication of radiation therapy. MRI findings include reversible cortical gyral edema and enhancement [1, 2]. Patient has given his written informed consent for publication, including publication of images. a b

中文翻译：

---

SMART（放射治疗后中风样偏头痛发作）综合征的经典临床和神经影像学发现

一名 50 岁男性患者在 20 年前接受过手术和全脑放射治疗以治疗转移性黑色素瘤，表现为偏头痛样头痛、癫痫发作和意识水平降低。MRI 显示皮质病变伴有水肿、弥散受限、脑回增强和左侧颞枕区灌注升高（图 1）。患者接受镇痛药和抗惊厥药治疗。6个月后，临床和影像学表现有所改善（图2）。SMART（放射治疗后中风样偏头痛发作）是放射治疗的良性晚期并发症。MRI 结果包括可逆性皮质回水肿和增强 [1, 2]。患者已书面同意出版，包括出版图像。AB