“Brief communications” concerning vascular neurologic disorders in the same issue of Ann Neurol include the following:

Stroke-like episodes in autosomal recessive cytochrome oxidase deficiency [1]. Three patients with autosomal recessive Saguenay-Lac St-Jean cytochrome oxidase (COX) deficiency from Quebec, Canada, developed acute focal neurologic dysfunction and frontal hypodensities on CT, suggesting cerebral ischemia. Arteriography in 1 patient was normal during the acute episode. Some patients subsequently developed Leigh’s disease (subacute necrotizing encephalomyelopathy). COX deficiency with congenital lactic acidosis is characterized by psychomotor retardation, hypotonia, and lactic acidemia.

Radiation-induced cerebral vasculopathy in children with neurofibromatosis and optic pathway glioma [2]. Neurofibromatosis 1 is a specific risk factor for radiation-induced cerebral vasculopathy. In a mean follow-up period of 7 years, 13 (19%) of 69 children with NF-1 and optic pathway glioma (OPG) developed occlusive vasculopathy within 36 months of therapy. Radiation therapy should be avoided as first-line therapy for OPG when possible.