Cerebral arterial disturbances in a transient encephalopathy induced by methotrexate.
The mechanism of the transient encephalopathy induced by high dose systemic administration of methotrexate (HDMTX) is unknown. Metabolic and vascular hypothesis have been formulated but convincing evidence is lacking. We report the first case of vascular disturbances (thinness of cortical arteries on angiography, reversible fall down of cerebral flow and increase of carotid resistance) in a young Algerian patient treated for an osteogenic osteosarcoma. This observation might lead to the exploration by non invasive and easily repeatable techniques of the cerebral vascular dynamic in patients submitted to HDMTX and thus contributed to the elucidation of the mechanism and to the prevention of these neurological side effect.
Follezou
J Y
JY
Service de Radiothérapie, Hôpital de la Pitié-Salpétrière, Paris, France.
Chauveinc
L
L
Guerin
J M
JM
D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000601:surgery; D002536:Cerebral Arteries / Q000187:drug effects*; D002560:Cerebrovascular Circulation / Q000187:drug effects; D002945:Cisplatin / Q000008:administration & dosage; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects*; D012516:Osteosarcoma / Q000188:drug therapy* / Q000601:surgery; D012640:Seizures / Q000139:chemically induced* / Q000503:physiopathology; D013577:Syndrome
D004317:Doxorubicin; D003520:Cyclophosphamide; D002945:Cisplatin; D002955:Leucovorin; D008727:Methotrexate