Stroke-like migraine attacks after radiation therapy (SMART) syndrome

Brain magnetic resonance axial T2-fluid-attenuated inversion recovery (FLAIR) (A) and postcontrast T1 (B) images of a patient with lung cancer who underwent prophylactic whole-brain radiation therapy many years earlier and presented with headache, dysphasia, and seizures. Imaging shows abnormal T2 hyperintensity (A) and avid enhancement (B) along the left frontoparietal cortex. He was diagnosed with strokelike migraine attacks after radiation therapy (SMART) syndrome, and his clinical and radiographic abnormalities spontaneously resolved over a few weeks, as shown on the axial postcontrast T1-weighted image (C).