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Radiation effects on the human central nervous system 14 weeks after X-radiation

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Summary

A case is reported in which neurological symptoms developed 8 weeks after radiation of a pituitary adenoma. Post mortem examination 14 weeks after radiation showed changes in the path of the beam similar to those seen in 2 other cases reported with a similar latent period, and to that produced in experimental animals. The changes consisted of demyelination, loss of oligodendroglia, the presence of abnormal giant astrocytes and increased vascularity with no obvious change in the vessel walls. The histological changes and the latent period are probably accounted for by a direct effect of radiation on the oligodendroglia and on the replicating mechanism of sensitive cells, particularly the astrocytes. The more commonly reported cases of changes seen after a much longer latent period and developing more slowly, could be produced in the same way. Vessel changes are very pronounced in these late cases, but they are not the only cause of the necrosis and are not necessarily indicative of a different sort of reaction to radiation.

Zusammenfassung

Bericht über einen Fall, bei dem neurologische Symptome 8 Wochen nach Bestrahlung eines chromophoben Hypophysenadenoms auftraten. Die autoptische Untersuchung 14 Wochen nach Bestrahlung zeigte Veränderungen im Strahlengangsbereich ähnlich jenen in zwei anderen Humanfällen mit gleicher Latenzzeit sowie bei experimentellen Strahlenschäden. Sie bestanden in Entmarkung, Verlust der Oligodendroglia, Auftreten abnormer Riesenastrocyten und gesteigerter Gefäßdichte ohne eindeutige Gefäßwandschäden. Die histologischen Läsionen und die Latenzzeit werden als mögliche Folge eines direkten Strahleneffekts auf die Oligodendroglia und auf die Teilungsmechanismen empfindlicher Zellen, besonders der Astrocyten, bezogen. Die häufiger beschriebenen Fälle mit langer Latenzzeit und langsamer Entwicklung der Gewebsschäden könnten auf gleiche Weise entstehen. Bei diesen Spätfällen sind Gefäßveränderungen stark ausgeprägt, doch sind diese nicht die einzige Ursache der Nekrose und stellen keinen unbedingten Beweis für eine andersartige Strahlenreaktion dar.

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Monro, P., Mair, W.G.P. Radiation effects on the human central nervous system 14 weeks after X-radiation. Acta Neuropathol 11, 267–274 (1968). https://doi.org/10.1007/BF00686723

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