We report two childhood germ cell tumor survivors treated for multifocal or large suprasellar tumors followed by the presentation of acute neurological deficits and extensive cortical laminar necrosis on magnetic resonance imaging (MRI), 7 and 34 months after cranial irradiation. This complication, though uncommon, represents another manifestation of delayed treatment-related brain injury that can be catastrophic and leads to significant morbidity.