By International Atomic Energy Agency
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Additional info for Accidental Overexposure of Radiotherapy Patients in San Jose, Costa Rica
Other patients examined by the Expert Team are not paralysed, but are nonetheless at major risk. Some examples of the patients at very high risk or with current problems in this regard were: (a) (b) (c) Patient No. 5 Gy per fraction to the spine; this places the patient above the 25–50% level of risk; Patient No. 8 Gy per fraction); any dose over 40 Gy with this fractionation scheme puts the patient at extremely high risk; the patient was experiencing early partial paralysis (the patient subsequently died); Patient No.
CENTRAL NERVOUS SYSTEM Several patients are already experiencing difficulties, or may be expected to do so in the future, as a result of irradiation of the brain, spinal cord and peripheral nerves. In general, radiotherapy of the brain results in cortical atrophy in a large number of cases . Of the children who received 20–65 Gy (with fractions of less than 2 Gy/d), over half will develop cortical atrophy, 26% will exhibit white matter changes (leukoencephalopathy) (Photograph 1) and 8% will suffer from calcifications.
This should be borne in mind when the total doses are examined. 49 Photograph 9. Permanent epilation, pigmentation and severe subcutaneous fibrosis after irradiation of the left groin. The patient also had limited movement of the left hip as a result of overexposure. Regrowth of hair often occurs even when radiation doses to the skin are high. A number of patients had permanent epilation, which attests to the high skin doses they had received (Photographs 10 and 11). Examples of such cases included: (1) 50 Patient No.