Neurotoxicity of intrathecal methotrexate: value of DWI in early detection
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Diffusion-weighted MR imaging of early methotrexate-related neurotoxicity in children.
BACKGROUND AND PURPOSE Methotrexate is a major cause of treatment-related acute neurotoxicity in children with hematologic malignancies. The purpose of this study was to investigate whether diffusion-weighted MR imaging (DWI) detects acute methotrexate white matter neurotoxicity in this patient population. METHODS Six children-three female and three male-with hematologic malignancies were stu...
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We report a case of intrathecal methotrexate neurotoxicity manifesting as left arm weakness and aphasia. Diagnostic imaging showed restricted diffusion and fluid-attenuated inversion recovery imaging findings were normal at presentation. Three weeks later, diffusion abnormalities resolved, and T2-weighted studies showed increased signal intensity of prolonged T2 changes in areas of prior restri...
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Intrathecal treatment with methotrexate, an essential chemotherapeutic for both prophylaxis and treatment of central nervous system involvement of leukemia, may be associated with local neurotoxicity and/or systemic toxicity. Signs of acute neurotoxicity include confusion, disorientation, seizures, aphasia, ataxia, dysarthria, paresis and even paralysis. Presented here is a case of a 58 year ol...
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Dear Editor, Methotrexate (MTX) is a frequently used chemotherapeutic agent in the treatment of childhood acute lymphoblastic leukaemia (ALL) and lymphoma. Besides oral and intravenous MTX, intrathecal MTX is an essential component of chemotherapy for ALL and is effective in preventing recurrences of central nervous system (CNS) leukaemia. Acute, subacute and chronic neurotoxicity have been obs...
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