title: Lumbar spinal fluid collections in children treated with intrathecal chemotherapy: elevated CSF protein as a diagnostic clue.
abstract: Subdural fluid collections can interfere with the effective intrathecal administration of chemotherapy by lumbar puncture (LP). We detected this complication in six children who were treated for acute lymphoblastic leukemia (ALL) and presented with an elevated protein concentration of the cerebrospinal fluid (CSF) during routine LP. Contrary to expectation the lumbar fluid collections persisted in two cases and in one case required the insertion of an Ommaya reservoir to continue intrathecal chemotherapy. Awareness and detection of this complication by imaging is important because of its potential to interfere with effective CNS-directed chemotherapy of ALL.
authors.affiliation: Division of Haematology/Oncology, Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Fahd
authors.initials: F
authors.lastname: Almanjomi
authors.forename: Derek
authors.initials: D
authors.lastname: Armstrong
authors.forename: Oussama
authors.initials: O
authors.lastname: Abla
authors.forename: Ahmed
authors.initials: A
authors.lastname: Naqvi
authors.forename: Sheila
authors.initials: S
authors.lastname: Weitzman
authors.forename: Johann
authors.initials: J
authors.lastname: Hitzler
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage*; D002556:Cerebrospinal Fluid Proteins / Q000032:analysis*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007278:Injections, Spinal; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000134:cerebrospinal fluid / Q000188:drug therapy*; D013129:Spinal Puncture / Q000009:adverse effects*
chemical_list: D000970:Antineoplastic Agents; D002556:Cerebrospinal Fluid Proteins