Criteria for the diagnosis of SMART:
(1) past history of external beam cranial irradiation (may be many years before)
(2) prolonged, reversible signs and symptoms (see below) referrable to a unilateral cortical region
(3) transient, diffuse, unilateral cortical gadolinium (contrast) enhancement of the cerebral gyri, sparing the what matter within a previous radiation field
(4) exclusion of alternative explanations (including residual or recurrent neoplasm)
where:
• In the original text residual or recurrent neoplasm was included with criterion 1.
• While the signs and symptoms are often reversible, some may persist.
Signs and symptoms may include:
(1)
visuo-spatial deficits
(2) confusion
(3) hemisensory deficits
(4) hemiparesis
(5) aphasia
(6) seizures
(7) headaches
(8) antecedent migraine with or without aura starting after irradiation
