In the last decades radiotherapy induced brain injury has become an emerging issue for physicians. Brain RT-induced injury has been classified, according to its time of onset, into acute, early delayed, and late forms. The latter is not reversible. Etiopathogenesys of brain damage after RT has been at length discussed, vascular injury and white matter pathologic changes have been described. In our study we described the neurological cognitive and behavioural disruption produced by radiotherapy in primary brain neoplasia; moreover we demonstrated that the effect of radiation on the brain has a classic time dependent course, with a severity related to total radiation dose, individual fraction size, and the volume of brain irradiated. The patients, who suffered from the consequence of RT, did show slowness of executive functions, and profound alterations of frontal functions, such as attention focusing, mentation control, analogical judgement and insight, not differently from those obtained by the patients suffering from subcortical vascular dementia. The overall result of high dose- RT might be a severely demented, bedridden patient, who “has been cured” for his primary disease, the brain tumour, but it constrains us to make serious consideration before radiation therapy onset and in order to implement new strategies to avoid this damage.
