To review the role of Radiation Neurotoxins in triggering, developing of radiation induced central nervous system injury. Radiation Neurotoxins – rapidly acting blood toxic lethal agent, which activated after irradiation and concentrated, circulated in interstitial fluid, lymph, blood with interactions with cell membranes, receptors and cell compartments.

1. Acute Radiation CerebroVascular
Syndrome. Part 1.
Advanced Medical Technology & Systems
Inc.
Dmitri Popov, PhD Radiobiology.

2. Acute Radiation Cerebrovascular
Syndrome.
 Key words:
 Cerebrovascular Acute Radiation Syndrome (Cv
ARS), Radiation Neurotoxins (RNT),
Neurotransmitters, Radiation Countermeasures,
Antiradiation Vaccine (ArV), Antiradiation Blocking
Antibodies, Antiradiation Antidote.
Psychoneuroimmunology, Neurotoxicity,
Autoimmunity.

3. Acute Radiation Cerebrovascular
Syndrome.
 Functional areas of human brain.

4. Acute Radiation Cerebrovascular
Syndrome.
Cerebrovascular circulation

5. Acute Radiation Cerebrovascular
Syndrome.
 To review the role of Radiation Neurotoxins in
triggering, developing of radiation induced central
nervous system injury.
 Radiation Neurotoxins – rapidly acting blood toxic
lethal agent, which activated after irradiation and
concentrated, circulated in interstitial fluid, lymph,
blood with interactions with cell membranes,
receptors and cell compartments.

6. Acute Radiation Cerebrovascular
Syndrome.
 Radiation Neurotoxins – biological
moleculesproteins with high enzymatic activity
and specific lipids, activated after irradiation.
 The Radiation Neurotoxins induce increased
permeability of blood vessels, disruption of the
blood-brain barrier, blood-cerebrospinal fluid
(CSF) barrier and developing severe disorder of
blood macro- and micro-circulation.

7. Acute Radiation Cerebrovascular
Syndrome
 Principles of Radiation Psychoneuro-immunology
and Psychoneuro-allergology were applied for
determination of pathological processes
developed after irradiation or selective
administration of Radiation Neurotoxins to
radiation naïve mammals.
 Effects of radiation and exposure to radiation can
develop severe irreversible abnormalities of
Central Nervous System, brain structures and
functions

8. Acute Radiation Cerebrovascular
Syndrome. Antiradiation Vaccine.
 Antiradiation Vaccine – most effective, advanced
methods of protection, prevention, mitigation and
treatment and was used for of Acute Radiation
Syndromes and elaboration of new technology
for immune-prophylaxis and immune-protection
against ϒ, Heavy Ion, Neutron irradiation and UV
Radiation.

9. Acute Radiation Cerebrovascular
Syndrome. Antiradiation Vaccine.
 Results of experiments suggested that blocking,
antitoxic,specific antiradiation antibodies can
significantly reduce toxicity of Radiation Toxins.
 New, advanced technology include active
immune-prophylaxis with Antiradiation Vaccine
and effective specific Antiradiation therapy that
included specific blocking antibodies to Radiation
Neurotoxins.

10. Acute Radiation Cerebrovascular
Syndrome.
 Antiradiation Vaccine and Antiradiation IgG
preparations – prospective effective
antidote/countermeasure for ϒ-irradiation, heavy
ions irradiation, neutron irradiation and UV
Radiation.

Recommendations for treatment and immune-prophylaxis
of CNS injury, induced by radiation,
were proposed. Specific immune therapy and
specific immune prophylaxis reduce symptoms of
ARCvS.

11. Acute Radiation Cerebrovascular
Syndrome.
 Cerebrovascular Acute Radiation Syndrome
(ARCv S) is an extremely severe, specific,
dynamic injury of Central Nervous System
(CNS) and Peripheral Nervous System (PNS).
 Toxic stimulation and inhibition of Autonomic
Nervous System – Parasympathetic and
Sympathetic Nervous System occur after
irradiation. Even small doses of radiation could
induce injury or disturbance of CNS, PNS and
gastrointestinal nervous system.

12. Acute Cerebrovascular Radiation
Syndrome.
 Grading System for Acute Cerebro-vascular
Radiation Syndrome based on general clinical
signs.
 Degree 1 – Mild form of ACvRS.
Radiation Neurotoxins – SRD 4.1;
Nausea, Vomiting - Occasional (once per day).
 Anorexia - Able to eat , appetite decreased.
 Fatigue syndrome – Able to work.
 Hypotension - Blood pressure>100/170 mm Hg.

13. Acute Cerebrovascular Radiation
Syndrome.
 Neurologic deficit – Detectable.
 Cognitive deficit – Detectable, minor.
 --------------------------------------------------------
 Degree 2 - Moderate Form.
 Radiation Neurotoxins : SRD – 4.2.
 Nausea, Vomiting - Intermitted (2-5 times per
day).
 Anorexia - Intake decreased.
 Fatigue syndrome - Impaired work ability.

14. Acute Cerebrovascular Radiation
Syndrome.
 Hypotension - Blood pressure <100/70 mmHg
 Neurologic deficit - Easy detectable.
 Cognitive deficit - Moderate loss.
 -------------------------------------
 Degree 3 – Severe form.
 Radiation Toxins type Group - SRD – 4.3.
 Nausea, Vomiting - Persistent (6-10 times per
day).
 Anorexia – Intake minimal

15. Acute Cerebrovascular Radiation
Syndrome.
 Fatigue syndrome - Need assistance in activity of
daily .
 Hypotension - Blood pressure <90/60 mm Hg
 Neurologic deficit - Prominent, severe form.
 Cognitive deficit - Major loss, severe cognitive
deficit.
 -----------------------------------------------------
 Degree 4 – Extremely Severe form.
 Radiation Neurotoxins form Group - SRD – 4.1.

16. Acute Cerebrovascular Radiation
Syndrome.
 Nausea, Vomiting - Extremely severe
 Refractory (>10 times per day).
 Anorexia - Parenteral nutrition.
 Fatigue syndrome - Severe fatique, need full
assistance for daily activity.
 Hypotension - Blood pressure <80/? Mm Hg;
 Neurological deficit ; Heart beat cessation - Life
threatening, unconsciousness, Possible breathing
and heart beat cessation. Need life support.
 Cognitive deficit - Complete impairment

17. Acute Cerebrovascular Radiation
Syndrome.
 Grading System of Acute Cerebrovascular
Radiation Syndrome based on psycho-neurological
signs and symptoms .
 Mild Grade of Cv ARS.
 Mild Psycho-neuroimmunological, psycho-neuro-immunotoxic
symptoms. Single subjective
symptoms: possible anxiety, fatigue, weakness or
headache. The principal effectors of radiation
induced activation of Sympathetic Nervous
System and Hypothalamic-Pituitary-Adrenal axis.
Disrupting balance between inhibitory and
excitatory neurotransmitters.

18. Acute Cerebrovascular Radiation
Syndrome.
 Moderate Grade of Cv ARS.
 Moderate Psycho-neuroimmunological, psycho-neuro-
immunotoxic symptoms.
 Multiple subjective symptoms: anxiety,
 fatigue, weakness and/or headache.
 Edema of brain structures. Inhibitory and excitatory
neurotransmitters counteractions. Radiation
exposure change the balance and increasing
functions of excitatory neurotransmitters – glutamate
and aspartate and decrease functions of inhibitory
neurotransmitters – GABA, glycine, adenosine.

19. Acute Cerebrovascular Radiation
Syndrome.
 Severe Grade of Cv ARS.
 Severe Psycho-neuroimmunological, psycho-neuro-
immunotoxic symptoms.
 Multiple subjective symptoms: anxiety,
 fatigue, weakness and/or headache.
Hypotension.
 Fever, mild confusion.
 Disruption of blood-brain barrier, blood-cerebrospinal
fluid (CSF) barrier, developing
severe disorder of blood macro- and micro-circulation.

20. Acute Cerebrovascular Radiation
Syndrome.
 Extremely severe Grade of Cv ARS.
 Extremely severe Psycho-neuroimmunological
symptoms, psycho-neuro-immunotoxic
symptoms. Intracortical, intra-parenchemal
bleeding. Severe disruption of blood-brain barrier,
blood-cerebrospinal fluid (CSF) barrier and
developing severe disorder of blood macro- and
micro-circulation. Shock.

21. Acute Radiation Cerebrovascular
Syndrome.
 Stages of Cerebrovascular Acute Radiation
Syndrome.
 Prodromal stage of CV ARS.
 Nausea, Vomiting, Watery diarrhea,
Disorientation, Confusion, prostration, Seizures.
Papilledema, ataxia, absent tendon and corneal
reflexes. Nervousness, Symptoms developing
dynamically and may last episodically.

22. Acute Radiation Cerebrovascular
Syndrome.
 Latent stage of CV ARS.
 This stage the patients developing partial
functionality
 Stage continuing for minutes , hours depend on
Grades of ARS. In some cases Latent stage of
CV ARS could be absent.

23. Acute Radiation Cerebrovascular
Syndrome.
 Manifest stage of CV ARS.
 Return of watery diarrhea,
 convulsions, coma
 The Glasgow Coma Scale allows a standard
assessment that include:
1. Eye opening - to loud voice ;
2. Reactions to pain; yes, none.
3. Verbal response - oriented; confused, disoriented;
speech.; None verbal response.
4. Motor Response - reaction to command ; pain
reactions; abnormal flexion posturing; extensor
posturing; movements – tremor, active movements,
absence.


24. Acute Radiation Cerebrovascular
Syndrome.
 Outcome stage of CV ARS.
 Patterns of abnormal breathing - Cheyne-Stokes
respiration or Kussmaul breathing.
The circulatory complications of hypotension,
cerebral edema, increased intracranial pressure,
and cerebral anoxia.
 Cessation of breathing, cessation of heart
beating.