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CC BY-NC-ND 4.0 · Asian J Neurosurg 2018; 13(03): 848-850
DOI: 10.4103/ajns.AJNS_324_16
Case Report

Methotrexate-induced leukoencephalopathy without typical restricted diffusion on diffusion-weighted imaging and the utility of magnetic resonance spectroscopy to support the diagnosis

Ninh Doan
Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
,
Mohit Patel
2   Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
,
Ha Nguyen
Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
,
Hayley Doan
3   New Berlin High School, New Berlin, Wisconsin
,
Saman Shabani
Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
,
Michael Gelsomino
Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
,
Andrew Mountoure
Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
,
Karl Janich
Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
,
Christopher Chitambar
1   Department of Medicine, Hematology/Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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Methotrexate (MTX) is a common antimetabolite agent that is widely used today in treating leukemia, lymphoma, and osteosarcoma. Its use has been associated with leukoencephalopathy causing seizures, paralysis, and even coma. To achieve the best possible outcome, it is important to be able to make a prompt diagnosis. Studies reported restricted diffusion on diffusion-weighted imaging (DWI) which is a reliable early sign of acute MTX-induced leukoencephalopathy. However, we report here the first case of MTX-induced leukoencephalopathy without typical restricted diffusion on DWI and the utility magnetic resonance spectroscopy to support this diagnosis in the difficult case such as the one being presented here.

Key-words:

Leukoencephalopathy - magnetic resonance spectroscopy - methotrexate


Publication History

Article published online:
14 September 2022

© 2018. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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