Mechanisms of radiation-induced brain injury are not yet fully understood. Early failure occurs because of the effect of ionizing radiation on dividing endothelialcells and oligodendrocytes. Hypothetically, late radiation-induced brain injury is causedby chronic inflammation and oxidative stress. In the case of irradiation of thehippocampus, the failure of neurogenesis and cognitive decline could be consequencesof such pathological mechanisms. Due to lack of diagnostic tools, that could not more precisely define the brain injury after radiation, therapy, that may prevent such consequences in patients who require radiotherapy, is not currently known. This articlesummarizes research hypotheses regarding processes of the brain damage after radiation, prospects in the diagnosis and therapeutic approaches.