Cerebral vasculopathy and multiple infarctions in a woman with carcinomatous meningitis while on treatment with intrathecal methotrexate.
We report on a 33-year-old woman with carcinomatous meningitis due to carcinoma of the breast who developed multiple cerebral infarctions within four days after intrathecal chemotherapy with methotrexate. MR angiography revealed a narrowing of basal cerebral arteries, which is consistent with vasculopathy. The vasculopathy was probably due to carcinomatous meningitis itself, an acute toxic effect of methotrexate, or a combination of both.
Kastenbauer
S
S
Department of Neurology, Klinikum Grosshadern, Ludwig-Maximilians University, Munich, Germany.
Wiesmann
M
M
Pfister
H W
HW
D000328:Adult; D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects*; D016893:Carotid Stenosis / Q000139:chemically induced / Q000473:pathology; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D020243:Infarction, Anterior Cerebral Artery / Q000139:chemically induced* / Q000473:pathology; D020244:Infarction, Middle Cerebral Artery / Q000139:chemically induced / Q000473:pathology; D007278:Injections, Spinal; D018810:Magnetic Resonance Angiography; D008577:Meningeal Neoplasms / Q000150:complications / Q000188:drug therapy*; D008581:Meningitis / Q000209:etiology; D008727:Methotrexate / Q000009:adverse effects*
D000964:Antimetabolites, Antineoplastic; D008727:Methotrexate