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Treatment of radiation-induced nervous system injury with heparin and warfarin.

Publication ,  Journal Article
Glantz, MJ; Burger, PC; Friedman, AH; Radtke, RA; Massey, EW; Schold, SC
Published in: Neurology
November 1994

When radiation is used to treat nervous system cancer, exposure of adjacent normal nervous system tissue is unavoidable, and radiation-induced injury may occur. Acute injury is usually mild and transient, but late forms of radiation-induced nervous system injury are usually progressive and debilitating. Treatment with corticosteroids, surgery, and antioxidants is often ineffective. We treated 11 patients with late radiation-induced nervous system injuries (eight with cerebral radionecrosis, one with a myelopathy, and two with plexopathies, all unresponsive to dexamethasone and prednisone) with full anticoagulation. Some recovery of function occurred in five of the eight patients with cerebral radionecrosis, and all the patients with myelopathy or plexopathy. Anticoagulation was continued for 3 to 6 months. In one patient with cerebral radionecrosis, symptoms recurred after discontinuation of anticoagulation and disappeared again after reinstitution of treatment. We hypothesize that anticoagulation may arrest and reverse small-vessel endothelial injury--the fundamental lesion of radiation necrosis--and produce clinical improvement in some patients.

Duke Scholars

Published In

Neurology

DOI

ISSN

0028-3878

Publication Date

November 1994

Volume

44

Issue

11

Start / End Page

2020 / 2027

Location

United States

Related Subject Headings

  • Warfarin
  • Spinal Cord Diseases
  • Radiation Injuries
  • Neurology & Neurosurgery
  • Necrosis
  • Middle Aged
  • Male
  • Humans
  • Heparin
  • Glioblastoma
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Glantz, M. J., Burger, P. C., Friedman, A. H., Radtke, R. A., Massey, E. W., & Schold, S. C. (1994). Treatment of radiation-induced nervous system injury with heparin and warfarin. Neurology, 44(11), 2020–2027. https://doi.org/10.1212/wnl.44.11.2020
Glantz, M. J., P. C. Burger, A. H. Friedman, R. A. Radtke, E. W. Massey, and S. C. Schold. “Treatment of radiation-induced nervous system injury with heparin and warfarin.Neurology 44, no. 11 (November 1994): 2020–27. https://doi.org/10.1212/wnl.44.11.2020.
Glantz MJ, Burger PC, Friedman AH, Radtke RA, Massey EW, Schold SC. Treatment of radiation-induced nervous system injury with heparin and warfarin. Neurology. 1994 Nov;44(11):2020–7.
Glantz, M. J., et al. “Treatment of radiation-induced nervous system injury with heparin and warfarin.Neurology, vol. 44, no. 11, Nov. 1994, pp. 2020–27. Pubmed, doi:10.1212/wnl.44.11.2020.
Glantz MJ, Burger PC, Friedman AH, Radtke RA, Massey EW, Schold SC. Treatment of radiation-induced nervous system injury with heparin and warfarin. Neurology. 1994 Nov;44(11):2020–2027.

Published In

Neurology

DOI

ISSN

0028-3878

Publication Date

November 1994

Volume

44

Issue

11

Start / End Page

2020 / 2027

Location

United States

Related Subject Headings

  • Warfarin
  • Spinal Cord Diseases
  • Radiation Injuries
  • Neurology & Neurosurgery
  • Necrosis
  • Middle Aged
  • Male
  • Humans
  • Heparin
  • Glioblastoma