Posterior leukoencephalopathy following intrathecal chemotherapy with MRA-documented vasospasm

• Published in: Neurology Vol. 60; no. 2; p. 326
• Main Authors: Henderson, R D, Rajah, T, Nicol, A J, Read, S J
• Format: Journal Article
• Language: English
• Published: United States 28.01.2003
• Subjects: Acute Disease; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Blindness - etiology; Brain Diseases - chemically induced; Brain Diseases - diagnosis; Brain Diseases - physiopathology; Cerebral Arteries - pathology; Cerebral Arteries - physiopathology; Cerebral Infarction - etiology; Cytarabine - administration & dosage; Cytarabine - adverse effects; Disease Progression; Female; Humans; Injections, Spinal; Magnetic Resonance Angiography; Magnetic Resonance Imaging; Methotrexate - administration & dosage; Methotrexate - adverse effects; Middle Aged; Ocular Motility Disorders - etiology; Precursor Cell Lymphoblastic Leukemia-Lymphoma - drug therapy; Recovery of Function; Syndrome; Tachycardia - complications; Tachycardia - diagnosis; Vasospasm, Intracranial - chemically induced; Vasospasm, Intracranial - diagnosis; Vasospasm, Intracranial - physiopathology
• ISSN: 1526-632X
• DOI: 10.1212/01.WNL.0000042095.49520.1E

Posterior leukoencephalopathy syndromes have been reported with hypertension, and immunosuppressive and chemotherapy agents. Cerebral vasospasm on MR angiography (MRA) has been noted in cases due to eclampsia. The authors report a case of Balint syndrome with irreversible posterior leukoencephalopathy on MRI following intrathecal methotrexate and cytarabine. Hypertension was not present. Diffuse, reversible arterial irregularities consistent with vasospasm were present on MRA during the acute illness.