RADIATION ENCEPHALOPATHY:—AN AUTOPSY CASE and SOME COMMENTS ON THE PATHOGENESIS OF DELAYED RADIONECROSIS OF CENTRAL NERVOUS SYSTEM

An autopsy case of radiation encephalopathy is reported. This case was bilaterally irradiated for epipharyngeal carcinoma with ,60Go (Total dosis of each side: 6020 r/20 fractions /23 days) and taken ill with the latent period of 2 years after the termination of the irradiation and had a clinical course of 3 years. The clinical symptoms and pathological findings including the distribution of vascular and parenchymal lesions were similar to other cases of radiation encephalopathy following irradiation to the hypophysis. From the findings of reconstruction of serial sections, the distribution of the lesions and the comparative study with the findings of reconstruction of serial sections of two autopsy cases of radiation myelopathy, it is considered that the pathogenesis of radiation encephalopathy and myelopathy is identical. Not only endothelial damage, but also circulatory disturbance of the venous system of definite areas, plays an important role for the determination of localisation and character of vascular and parenchymal changes.