Radiation-Induced Cutaneous Tissue Reactions in Neurointerventional Procedures: A Systematic Review of Reported Effects and Associated Dose Levels

This systematic review examined radiation-induced cutaneous tissue reactions in neurointerventional procedures, focusing on the associated radiation doses. The review included 25 studies with approximately 686 patients from 11 countries. Alopecia/epilation was the most common reaction, reported in 21 studies, while dermatitis/erythema and ulceration/necrosis were less frequent. The incidence of reactions ranged from 5% to 56%, increasing with higher skin doses and more complex procedures. Temporary epilation typically occurred around the 3 Gy threshold, while erythema and ulceration were associated with higher doses. Alopecia appeared 2-5 weeks post-procedure, and ulceration could manifest months to years later. The review highlighted inconsistencies in dose metrics and emphasized the need for standardized reporting of peak skin dose and structured follow-up based on dose triggers.