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Acute methotrexate-related neurotoxicity and pseudo-stroke syndrome.
We describe five episodes of transient acute leukoencephalopathy mimicking a stroke, reported in the literature as "pseudo-stroke syndrome". Neurologic symptoms occurred 3-10 days after IV or IT methotrexate and manifested as aphasia and alternating sensorimotor deficit. The fluctuating symptomatology regressed completely within a few days. Brain MRI, which is essential for diagnosis, demonstrated early white matter diffusion restriction in the affected cerebral area. These anomalies disappeared in one week, while hyperintense T2 FLAIR signals developed in the corresponding brain areas. The long-term progression of thes...
Source: Archives de Pediatrie - November 13, 2017 Category: Pediatrics Authors: Deneux V, Leboucq N, Saumet L, Haouy S, Akbaraly T, Sirvent N Tags: Arch Pediatr Source Type: research

SickKids Handbook of Pediatric Thrombosis and Hemostasis
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Source: Acta Paediatrica - October 4, 2013 Category: Pediatrics Authors: Ellen Ruud Tags: Book Review Source Type: research

Severe Cerebral Vasospasm and Childhood Arterial Ischemic Stroke After Intrathecal Cytarabine
We report on 2 patients who developed widespread cerebral vasospasm and arterial ischemic strokes (AIS) after application of intrathecal (IT) cytarabine. In a 3-year-old child with acute lymphoblastic leukemia (ALL), left leg weakness, hyperreflexia, and clonus were noted 4 days after her first dose of IT cytarabine during the induction phase of her chemotherapy. Cerebral MRI revealed multiple acute cerebral ischemic infarcts and widespread cerebral vasospasm. A 5-year-old girl complained of right arm and leg pain and began limping 11 days after IT cytarabine. Symptoms progressed to right dense hemiplegia, left gaze deviat...
Source: PEDIATRICS - February 1, 2016 Category: Pediatrics Authors: Tibussek, D., Natesirinilkul, R., Sun, L. R., Wasserman, B. A., Brandao, L. R., deVeber, G. Tags: Hematology/Oncology, Cancer/Neoplastic, Neurology, Neurologic Disorders Case Report Source Type: research