title: Fatal hemorrhage after radiochemotherapy for leptomeningeal dissemination of glioma: report of two cases.
abstract: BACKGROUND
  Dissemination of malignant gliomas is often observed, but the treatment of choice for leptomeningeal dissemination has not been established.
  
  
  METHODS
  A 55-year-old man suffered fatal hemorrhage 1 day after whole brain irradiation (2 Gy) along with intravenous administration of 150 mg of nitrosourea (ACNU) for leptomeningeal dissemination of glioblastoma. A 14-year-old boy suffered hemorrhage after intrathecal administration of 10 mg of methotrexate for recurrence of leptomeningeal dissemination of anaplastic astrocytoma 4 months after local brain irradiation and ACNU administration, and died 19 days later.
  
  
  CONCLUSIONS
  Massive fatal hemorrhage is an unusual but possible acute complication after radiochemotherapy for leptomeningeal dissemination of gliomas.
authors.affiliation: Department of Neurosurgery, Tohoku University School of Medicine, Sendai, Japan.
authors.forename: Ryuta
authors.initials: R
authors.lastname: Saito
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Kumabe
authors.forename: Hidefumi
authors.initials: H
authors.lastname: Jokura
authors.forename: Takashi
authors.initials: T
authors.lastname: Yoshimoto
mesh_terms: D000293:Adolescent; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001254:Astrocytoma / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D003131:Combined Modality Therapy; D017809:Fatal Outcome; D005909:Glioblastoma / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D008727:Methotrexate / Q000009:adverse effects*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011878:Radiotherapy / Q000009:adverse effects*; D013345:Subarachnoid Hemorrhage / Q000209:etiology*; D013997:Time Factors; D014057:Tomography, X-Ray Computed
chemical_list: D000970:Antineoplastic Agents; D008727:Methotrexate