Vasculopathy is a general term used to describe any condition that affects the blood vessels. Certain treatments, such as radiation used for cancer, can cause vasculopathy. When this occurs, it is known as radiation-induced vasculopathy.
This condition causes narrowing of the blood vessels, known as a lesion, which reduces the amount of blood flow through the vessel and can affect different areas of the body. Radiation-induced vasculopathy can be reversible in some cases. This outcome is affected by the location and size of the lesion.
However, serious complications such as a stroke can be associated with radiation-induced vasculopathy.
Radiation-induced vasculopathy is very similar to Moyamoya disease, which can sometimes lead to misdiagnosis.
The most common symptom of radiation-induced vasculopathy is a headache due to limited blood flow (ischemia) to the brain.
Ischemia can result in an ischemic stroke or transient ischemic attacks (TIA). If you notice one or more of these signs in another person or in yourself, do not wait to seek help. Call 9-1-1 immediately.
The signs of a stroke are:
- Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
- Sudden confusion
- Sudden trouble speaking
- Sudden trouble seeing in one or both eyes
- Sudden trouble walking
- Sudden dizziness, loss of balance or coordination
- Sudden, severe headache with no known cause
The effects of an acute ischemic stroke may cause additional symptoms in women including:
- Face, arm or leg pain
- Hiccups or nausea
- Chest pain or palpitations
- Shortness of breath
Radiation-induced vasculopathy can also result in sudden bleeding in the brain, known as a hemorrhagic stroke. Symptoms of a hemorrhagic stroke include:
- Numbness, weakness or inability to move (paralysis) of the face, arm or leg, especially on one side of the body
- Trouble seeing in one or both eyes, such as dimness, blurring, double vision or loss of vision
- Confusion or trouble speaking
- Trouble walking, dizziness or loss of balance or coordination
- Severe headache with no known cause
Causes and Risk Factors
Radiation-induced vasculopathy is caused by radiation treatment for another condition such as a brain tumor. The radiation causes the affected blood vessels to narrow and this limits the blood flow to the area. Therefore, patients who have had radiation treatment are at an increased risk of developing the condition.
Radiation-induced vasculopathy can occur in both men and women at any age. However, symptoms of the condition usually are first noticed in patients under the age of 18. Symptoms tend to occur six to eight years after radiation treatment was administered.
Diagnosis of radiation-induced vasculopathy usually begins with a physical exam and a review of the patient's medical history and symptoms. A positive diagnosis of radiation-induced vasculopathy is based on the patient’s symptoms as well as the findings of diagnostic tests.
Imaging tests, including magnetic resonance imaging (MRI) and computed tomography (CT) angiography, can be used to diagnosed the condition and observe the area affected by constricted blood vessels. These imaging tests look at the soft tissue and blood vessels within the body and can determine if the condition is associated with a stroke or other underlying issues.
Treatment of radiation-induced vasculopathy will depend on the severity of the condition.
For minor cases, treatment usually is focused on using medications to relax the blood vessels and allow better blood flow. Aspirin is an over-the-counter medication that may be prescribed to help prevent blood clots from forming.
For patients who have experienced a stroke, the comprehensive Stroke Program at Cedars-Sinai provides a multidisciplinary treatment approach through a personalized treatment plan tailored to each patient. Patient care is generally broken down into three categories: stroke prevention, treatment immediately after a stroke, and post-stroke rehabilitation.