Mechanisms of post-radiation injury: cerebral microinfarction not a significant factor

J. A. Molad, D. T. Blumenthal, F. Bokstein, M. Findler, I. Finkel, N. M. Bornstein, S. Yust-Katz, E. Auriel*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Post-radiation leukoencephalopathy is characterized by cognitive impairment and white matter alternations on imaging. Cerebral small vessel disease (SVD) is one of several suggested etiologies. Cerebral microinfarction (CMI) is a recently described marker of SVD. We sought to examine the rate of CMI as a biomarker of ongoing ischemia among patients who underwent brain radiotherapy (RT). 110 patients treated with RT for primary or metastatic brain tumors were enrolled. A total of 685 brain MRI tests performed 1–108 months post-radiation were examined. The annual incidence of CMI was calculated. Only 2 definite CMI were found (2/685, 0.3 %). The calculated annual incidence of CMI was 0.11. This incidence is similar to the normal population, and lower than the reported incidence in patients with intracerebral hemorrhage or cognitive impairment. CMI incidence in patients treated with brain RT is similar to the general population. This finding suggests that post-radiation leukoencephalopathy and cognitive impairment are not due to active SVD solely but rather secondary to other causes such as inflammation, metabolic or direct cell damage.

Original languageEnglish
Pages (from-to)277-281
Number of pages5
JournalJournal of Neuro-Oncology
Issue number2
StatePublished - 1 Jan 2017


  • Cerebral microinfarct
  • Post-radiation leukoencephalopathy
  • Small vessel disease


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