Title : A rare case of SMART syndrome presenting to the emergency department
Abstract:
SMART syndrome (Stroke-like Migraine Attacks after Radiation Therapy) is an uncommon, delayed complication following cranial irradiation. It typically presents with transient, stroke-like neurological deficits such as hemiparesis, seizures, aphasia, sensory disturbances, and headaches. Due to its rarity and overlapping features with more common neurological conditions, diagnosis can be challenging.
We aim to present a rare case encountered in our hospital's emergency department. Given the diagnostic complexity and limited awareness of SMART syndrome, we believe this case is highly suitable for presentation at the International Neurology Conference to help raise awareness and enhance clinical recognition of this rare entity.
As we are currently preparing the full manuscript for publication, we have chosen not to submit the entire abstract at this stage. However, a summary of the case is provided below:
Case Summary: We report the case of a 63-year-old man with a past medical history of oligodendroglioma treated with cranial irradiation in 2015. In 2025, he presented to the emergency department with sudden-onset left-sided weakness affecting both the upper and lower limbs. A comprehensive evaluation, including neuroimaging and exclusion of alternative diagnoses, supported a final diagnosis of SMART syndrome, with the patient's history of cranial irradiation and characteristic MRI findings playing a key role.
For our conference presentation, we will provide a detailed overview of the patient’s clinical presentation, the investigations undertaken by the clinical team, and the diagnostic process, including a review of the patient’s imaging (with appropriate consent obtained).
We will outline the reasoning that led to the final diagnosis of SMART syndrome, the treatment strategies implemented, and the patient’s current clinical status. Additionally, the presentation will include a concise discussion of SMART syndrome itself to provide context and enhance understanding of this rare condition.
