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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

Targeting Inflammation and Immune System in Acute Myocardial Infarction.
Authors: Alwi I Abstract Over more than two decades, the concept of atherosclerosis has developed and lead to inflammatory hypothesis. Inflammation plays an important role on pathogenesis of atherothrombosis and coronary heart disease (CHD), including acute coronary syndrome (ACS). Although the management of ACS has been demonstrated to be beneficial for secondary prevention of coronary heart disease (such as using statin and aspirin) and also seemed to have positive effect on inflammation, the identification of effective management, specifically targeting inflammation, has been not been comprehensively understood....
Source: Acta medica Indonesiana - February 13, 2020 Category: Internal Medicine Tags: Acta Med Indones Source Type: research

Acute Neurotoxicity during ALL Therapy Is Associated with Treatment Intensity, Age and Female Sex - an Analysis of SAE Reports from the UKALL 2003 Trial
Discussion:This large study identifies treatment intensity as the main risk factor for developing acute neurotoxicity with female sex, age and CNS status having a significant modifying effect. CNS status may reflect increased intrathecal therapy given to non-CNS-1 patients. Females are more vulnerable to cranial radiotherapy induced neurotoxicity but this is the first report of female sex as a risk factor on contemporary chemotherapy treatment protocols. Reassuringly, the occurrence of acute neurotoxicity did not influence survival rates. These data provide an important benchmark for ongoing international deep phenotyping ...
Source: Blood - November 21, 2018 Category: Hematology Authors: Wahid, Q.-u.-A., Hamadeh, L., McGowan, S., Hough, R., Vora, A., Moorman, A. V., Halsey, C. Tags: 612. Acute Lymphoblastic Leukemia: Clinical Studies: Poster I Source Type: research

Differential diagnosis of stroke: Subacute leukoencephalopathy following high-dose methotrexate therapy in a young patient with osteosarcoma
We describe the case of a thirty-year-old man with a subacute leukoencephalopathy following high-dose methotrexate treatment which resembled a stroke in terms of clinical presentation and MR-tomography.
Source: Interdisciplinary Neurosurgery - February 16, 2016 Category: Neurosurgery Source Type: research

Closing the loop on inflammation and atherothrombosis: why perform the CIRT and CANTOS trials?
Authors: Ridker PM Abstract Inflammation contributes to all phases of the atherothrombotic process, patients with elevated inflammatory biomarkers such as high-sensitivity C-reactive protein (hsCRP) have increased cardiovascular risk, and recent work directly implicates the interleukin-1 (IL-1) and interleukin-6 (IL-6) pathways in atherogenesis. Yet, it remains unknown whether targeted inhibition of inflammation will reduce cardiovascular event rates. To address directly this fundamental hypothesis, our research group has initiated two large-scale, randomized, placebo-controlled trials using targeted anti-inflammat...
Source: Transactions of the American Clinical and Climatological Association - June 4, 2015 Category: Journals (General) Tags: Trans Am Clin Climatol Assoc Source Type: research

Methotrexate Encephalopathy as a Cause of Alternating Hemiplegia (P3.143)
CONCLUSIONS: Transient neurologic dysfunction with reversible MRI abnormality is a recognized consequence of intrathecal methotrexate chemotherapy in childhood ALL. Patients present with dramatic fluctuating neurologic symptoms with associated MRI changes and may be mistaken for stroke or a seizure disorder. Once the syndrome is recognized patients typically recover with supportive management and rehabilitation.Disclosure: Dr. Sullivan has nothing to disclose. Dr. Quealy has nothing to disclose. Dr. Olsevskaite has nothing to disclose. Dr. MacEneaney has nothing to disclose. Dr. Ryan has nothing to disclose. Dr. O'Toole ha...
Source: Neurology - April 8, 2015 Category: Neurology Authors: Sullivan, C., Quealy, J., Olsevskaite, J., MacEneaney, P., Ryan, C., O'Toole, O. Tags: Neuro-oncology: CNS Lymphoma and Other Hematologic Malignancies Source Type: research

Methotrexate induced leucoencephalopathy: A stroke mimic
We describe the case of a 17 year old girl with acute lymphoblastic leukemia, who developed stroke like episodes on two consecutive challenges with a chemotherapeutic regime which included intravenous and intrathecal methotrexate. She had MRI changes consistent with acute ischemic stroke on both occasions. Her deficits recovered completely and spontaneously, as did the MRI changes. She did not have any further episodes when methotrexate was excluded from the chemotherapeutic regime.
Source: Annals of Indian Academy of Neurology - August 26, 2013 Category: Neurology Authors: Tushar D GosaviMohammed Tauqeer AhmadLai-Heng LeeShih-Hui Lim Source Type: research