DELAYED RADIATION MYELOPATHY OF THE CERVI CAL SPINAL-CORD - A CASE-REPORT

A case of delayed progressive radiation myelitis (DPRM) which begin 11 months after naso pharyngeal carcinoma radiation, in a young man, is reported. The initial manifestation is often a Brown-Sequard's syndrom e progressing to complete and permanent myelopathy, with notable absen ce of localized or radicular pain. The parenchymal change of the spina l cord in radiation myelopathy can be easily visualized with magnetic resonance imaging (MRI) however there may be cases in which MRI appear ance alone does not distinguish specially between tumor and radiation necrosis with absolute confidence: therefore, DPRM is by necessity a d iagnosis of exclusion, based on clinical, paraclinical results and cou rse of disease. Corticosteroid therapy is accompanied by a significant remission of symptoms. The evolution is characterized by a worse prog nosis, prevention is absolutely necessary based on perfect radiation t echnic, knowledge on tolerance of spinal cord to irradiation (time-dos e-volume factors) and other risks factors (chemotherapy, age and vascu lar disease).