title: 5-fluorouracil-induced leukoencephalopathy with acute stroke-like presentation fulfilling criteria for recombinant tissue plasminogen activator therapy.
abstract: A 61-year-old man underwent systemic chemotherapy with intravenous infusion of nedaplatin and 5-fluorouracil. On the day after the final drug administration, he suddenly experienced difficulty in speaking followed by left-sided weakness. His National Institutes of Health Stroke Scale score was 12. A computed tomographic scan of the brain performed 4 hours after symptom onset revealed no abnormalities. Because all eligibility criteria were fulfilled, he immediately underwent intravenous recombinant tissue plasminogen activator therapy. He recovered from neurologic complications on day 14. An initial magnetic resonance imaging scan of his brain revealed a hyperintense area in the bilateral white matter and corpus callosum, and these abnormalities had improved on the follow-up scan. We diagnosed him with 5-fluorouracil-induced leukoencephalopathy with acute stroke-like presentation. Our experience suggests that 5-fluorouracil-induced leukoencephalopathy potentially fulfills all eligibility criteria for recombinant tissue plasminogen activator therapy.
authors: Department of Internal Medicine, Showa University Northern Yokohama Hospital, Kanagawa, Japan. Electronic address: kinno@med.showa-u.ac.jp.
authors: Ryuta
authors: R
authors: Kinno
authors: Department of Rehabilitation Medicine, Showa University Northern Yokohama Hospital, Kanagawa, Japan.
authors: Yoshitaka
authors: Y
authors: Kii
authors: Department of Internal Medicine, Showa University Northern Yokohama Hospital, Kanagawa, Japan.
authors: Masanobu
authors: M
authors: Uchiyama
authors: Department of Internal Medicine, Showa University Northern Yokohama Hospital, Kanagawa, Japan.
authors: Yoshiyuki
authors: Y
authors: Owan
authors: Department of Internal Medicine, Showa University Northern Yokohama Hospital, Kanagawa, Japan.
authors: Takahiro
authors: T
authors: Yamazaki
authors: Department of Internal Medicine, Showa University Northern Yokohama Hospital, Kanagawa, Japan.
authors: Toshiya
authors: T
authors: Fukui
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007262:Infusions, Intravenous; D056784:Leukoencephalopathies / Q000139:chemically induced / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins / Q000008:administration & dosage; D020127:Recovery of Function; D020521:Stroke / Q000139:chemically induced / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D015912:Thrombolytic Therapy; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator; D005472:Fluorouracil
keywords: 5-fluorouracil; leukoencephalopathy; recombinant tissue plasminogen activator; stroke-like presentation