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Methotrexate-Induced Stroke-Like Encephalopathy: Beware the Stroke Mimic
We report a case of methotrexate (MTX)-induced stroke-like encephalopathy in an 18-year-old woman, with acute lymphoblastic leukemia, who developed a sudden neurological deficit mimicking a cerebrovascular event. Bain MRI showed hyperintensities on diffusion-weighted-imaging (DWI) with matching apparent diffusion coefficient hypointensities, which also represent the commonest MRI findings in acute cerebral infarction. DWI changes spared the cerebral cortex and did not respect vascular territories, supporting a non-vascular mechanism. MRI plays a crucial role in the diagnostic work-up   and is essential to avoid unnecessar...
Source: Journal of the Belgian Society of Radiology - October 31, 2022 Category: Radiology Source Type: research

Hacking The Nervous System
(Photo: © Job Boot) One nerve connects your vital organs, sensing and shaping your health. If we learn to control it, the future of medicine will be electric.When Maria Vrind, a former gymnast from Volendam in the Netherlands, found that the only way she could put her socks on in the morning was to lie on her back with her feet in the air, she had to accept that things had reached a crisis point. “I had become so stiff I couldn’t stand up,” she says. “It was a great shock because I’m such an active person.”It was 1993. Vrind was in her late 40s and working two jobs, athletics coach and a carer for disabled ...
Source: Healthy Living - The Huffington Post - May 30, 2015 Category: Consumer Health News Source Type: news

Teaching NeuroImages: Methotrexate neurotoxicity: Resolution and evolution of MRI changes within 48 hours
A 13-year-old girl presented with acute-onset right hemiparesis involving the face, arm, and leg equally. She was receiving weekly intrathecal methotrexate (last dose 6 days prior) for recently diagnosed acute lymphocytic leukemia. Brain MRI (figure 1) showed diffusion restriction in the left centrum semiovale with reduced apparent diffusion coefficient. Her hemiparesis resolved within 24 hours but 2 hours later, she developed 12-hour left hemiparesis involving face, upper limb, and dysarthria. Follow-up neurologic examination was normal. Repeat MRI (figure 2) 44 hours after the original MRI showed acute right centrum semi...
Source: Neurology - September 2, 2013 Category: Neurology Authors: Kanaan, S., Poddar, K., Ng, Y.-T. Tags: Childhood stroke, MRI, DWI, Chemotherapy-tumor, All Pediatric RESIDENT AND FELLOW SECTION Source Type: research