PRES (No./%) | Cerebral venous thrombosis (No./%) | Methotrexate neurotoxicity (No./%) | |
---|---|---|---|
Number of patients | 41 (65%) (Males = 30, females = 11) | 16 (25%) (Males = 11, females = 5) | 6 (10%) (Males = 2, females = 4) |
Clinical picture | Seizures (34) Headache (7) Consciousness alteration (6) Visual abnormality (6) Others clinical manifestation (12) | Headache (12) Seizures (4) Loss of consciousness (2) Visual abnormalities (1) | Seizures (3) altered mental status (1) Left-sided facial droop and slurred speech (1) One-sided weakness (1) |
The percentage of patients using this type of chemotherapy | IV vincristine (87.8%) Intrathecal (ITH) methotrexate, Ara C, hydrocortisone (87.8%) IV doxorubicin (51.2%) Oral prednisone (90.2%) IV l-asparaginase (46.3%) IV cyclophosphamide (46.3%) IV bleomycin, vinblastine, dacarbazine, oxaliplatin, cisplatin (2.4%) | IV vincristine (100%) Intrathecal (ITH) methotrexate, Ara C, hydrocortisone (100%) IV doxorubicin (100%) Oral prednisone (100%) IV l-asparaginase (81.3%) IV methotrexate (50%) IV cyclophosphamide (37.5%) Oral 6 mercaptopurine (12.5%) | All these patients are receiving intrathecal methotrexate, and the time between the intrathecal methotrexate and the occurrence of symptoms ranged from 6 to 13 days |
Imaging findings | Hyperintense signal on T2WI and FLAIR images and iso to hypointense signal on T1WI | Non-visualization of occluded veins or sinuses due to absent signal and flow defects | Restriction in diffusion-weighted images (bright signal) in centrum semiovale |