68 year old man with aphasia and facial droop © 2014 American Academy of Neurology Teaching NeuroImages Neurology Resident and Fellow Section.

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Presentation transcript:

68 year old man with aphasia and facial droop © 2014 American Academy of Neurology Teaching NeuroImages Neurology Resident and Fellow Section

VIGNETTE A 68 year old man with a history of squamous cell carcinoma of the tongue treated with external beam radiation therapy in 2007, presented in 2013 with acute onset of expressive aphasia and right facial droop. MRI confirmed an infarct in the left frontal cortex. CTA revealed occlusion of the left internal carotid artery, new from 2007 imaging. Examination of the patient’s neck revealed radiodermatitis present only on the left. Ehrlich, et al. © 2014 American Academy of Neurology

IMAGING AB C D Ehrlich, et al. © 2014 American Academy of Neurology

Radiation-Associated Internal Carotid Artery Occlusion with Asymmetric Radiodermatitis Therapeutic neck irradiation has been associated with accelerated atheromatous changes, stenosis of the carotid arteries and increased risk of stroke. 1, 2 Asymmetric radiodermatitis may be a sign of underlying vasculopathy. Ehrlich, et al. © 2014 American Academy of Neurology