Reference work entry
Radiation injury to the central nervous system can result in catastrophic injury to the brain or spinal cord, to which rapidly dividing tumor cells, glial, neuronal stem cells, and endothelial cells are particularly sensitive. Parameters that exacerbate or moderate radiation injury are: (1) host factors of age, white matter risk, and genetic risk; (2) the temporal phase of the effects: acute, early-delayed, and late-delayed; (3) concurrent clinical factors, such as hypertension and diabetes; (4) the radiotherapeutic technique (e.g., whole brain vs. proton therapy); and (5) cellular radiosensitivity: Bergonié-Tribondeau law. However, other factors are emerging, such as oligodendrocytes, astrocytes, and endothelial cells also promote/regulate the hippocampal microenvironment (Greene-Schloesser et al. 2012). See figures (Fig. 1a, b) for an example of radiation injury 5 years after treatment in a highly educated, 50-year-old male in whom there were also...
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