Stroke-like migraine attack after radiation therapy (SMART) syndrome in a pediatric patient with a ventriculoperitoneal shunt: illustrative case
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
BACKGROUND: Stroke-like migraine attack after radiation therapy (SMART) syndrome is a rare, episodic neurological condition characterized by headache and unilateral cortical deficits following remote cranial radiation therapy. It is more frequently reported in adults, while pediatric cases remain exceedingly rare due to the latency period between radiation therapy and onset, which can span years to decades. Diagnosis is challenging due to overlapping symptoms with conditions like ventriculoperitoneal shunt (VPS) malfunction. OBSERVATIONS: The authors report the case of an 11-year-old boy with SMART syndrome following radiation treatment for a resected pineal region nongerminomatous germ cell tumor and VPS placement. The patient presented with headache, vomiting, lethargy, and seizures, raising initial concern for shunt malfunction. MRI revealed left occipital and posterior temporal cortical FLAIR hyperintensity and abnormal leptomeningeal enhancement, consistent with SMART syndrome. Multidisciplinary evaluation ruled out shunt failure and tumor recurrence. A course of corticosteroids led to symptom resolution. A review of 15 pediatric cases highlights variability in latency, symptoms, and treatment, with most patients responding favorably. LESSONS: SMART syndrome, although rare, should be considered in pediatric patients with postradiation episodic neurological symptoms to avoid unnecessary interventions. Multidisciplinary collaboration is essential. Further studies are needed to establish standardized diagnostic and treatment protocols. https://thejns.org/doi/10.3171/CASE25189.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it