Radiation Necrosis (Brain)

Radiation necrosis is a delayed complication of cranial radiotherapy characterized by focal brain tissue injury and necrosis. Clinical manifestations include headache, focal neurological deficits, seizures, and cognitive decline. Pathophysiology involves vascular injury, demyelination, and necrotic neuronal death. Diagnosis relies on MRI, perfusion imaging, and histopathology to differentiate from tumor recurrence. Management includes corticosteroids, anti-angiogenic therapy (bevacizumab), and surgical resection if symptomatic; prognosis depends on lesion location and response to therapy.