Table of Contents
Washington University Experience | MYELIN (NON-IMMUNE MEDIATED) | Delayed Radionecrosis | 4A0 Case 4 History
Case 4 History ---- The patient was a 25 year old woman who was first admitted to Barnes Hospital in May of 1975 with complaints of headache, papilledema and a right field cut. During this admission, workup revealed a large glioblastoma in the left occipital area and a right homonymous hemianopsia. She was treated with 6000 rads of radiation to the involved area and was begun on CCNU monthly. In March 1977 she was admitted to the hospital with a left hemianopsia and decreased sensation in the left body. An EMI scan done on that admission showed decreased density in the right parietal region thought to represent radiation necrosis. An EMI scan done in September 1977 showed no new tumor growth but only radiation changes which were apparently unchanged from March 1977. In June 1978 the patient was admitted with a cough and a 104oF which proved to be pneumonia, which was treated with multiple antibiotics. In July the patient developed new seizures controlled with increased Dilantin and Phenobarbital, although repeat CT was unchanged. The patient became unresponsive, thought to reflect a pontine lesion, diffuse tumor seeding or CNS vasculitis. The patient remained unresponsive, became hypoxic and hypotensive and expired three plus years following her radiation therapy.
