Vasospasm is a significant factor in cyclosporine-induced neurotoxicity: case report.
BACKGROUND
The aetiology of central nervous system lesions observed in cerebral cyclosporine neurotoxicity remains controversial.


METHODS
We report a 48-year-old woman with a non-severe aplastic anaemia who presented with stroke-like episodes while on cyclosporine treatment.Transcranial Doppler ultrasound revealed severely elevated flow velocities in several cerebral vessels, consistent with vasospasm. Immediately after reducing the cyclosporine dose, the stroke-like episodes disappeared. Only after cyclosporine withdrawal the transcranial Doppler ultrasound abnormalities fully resolved.


CONCLUSIONS
This case demonstrates a significant role of vasospasm in the pathway of cyclosporine-induced neurotoxicity. Transcranial Doppler ultrasound is an effective tool for the diagnosis and follow-up of cyclosporine-induced vasospasm.
Braakman
Hilde M H
HM
Department of Neurology, Maastricht University Medical Centre, Maastricht, the Netherlands. h.braakman@mumc.nl
Lodder
Jan
J
Postma
Alida A
AA
Span
Lambert F R
LF
Mess
Werner H
WH
D000935:Antifungal Agents / Q000009:adverse effects*; D016572:Cyclosporine / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008875:Middle Aged; D020258:Neurotoxicity Syndromes / Q000150:complications* / Q000209:etiology*; D020521:Stroke / Q000188:drug therapy; D017585:Ultrasonography, Doppler, Transcranial / Q000379:methods; D020301:Vasospasm, Intracranial / Q000000981:diagnostic imaging / Q000209:etiology*
D000935:Antifungal Agents; D016572:Cyclosporine
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