Focal encephalopathy following methotrexate therapy. Administration via a misplaced intraventricular catheter.
Publication/Presentation Date
7-1-1981
Abstract
Two patients with lymphoreticular malignant neoplasms and leptomeningeal tumor spread were treated with intraventricular administration of methotrexate via an Ommaya reservoir. The intraventricular instillation of methotrexate resulted in focal CNS damage in brain parenchyma inadvertently pierced by the shunt. Disorientation, aphasia, and right hemiparesis developed in both patients. Computed tomography disclosed a contrast-enhancing, low-density mass in the left cerebral cortex where the distal shunt tip was lodged. In one case the lesion was pathologically consistent with chronic inflammation. A lesion occurred in one patient despite repositioning of the shunt prior to methotrexate instillation. Shunt removal and administration of systemic corticosteroids resulted in resolution of symptoms in one patient.
Volume
38
Issue
7
First Page
450
Last Page
452
ISSN
0003-9942
Published In/Presented At
Packer, R. J., Zimmerman, R. A., Rosenstock, J., Rorke, L. B., Norris, D. G., & Berman, P. H. (1981). Focal encephalopathy following methotrexate therapy. Administration via a misplaced intraventricular catheter. Archives of neurology, 38(7), 450–452. https://doi.org/10.1001/archneur.1981.00510070084016
Disciplines
Diagnosis | Medicine and Health Sciences | Other Analytical, Diagnostic and Therapeutic Techniques and Equipment | Radiology
PubMedID
7247768
Department(s)
Department of Radiology and Diagnostic Medical Imaging
Document Type
Article