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Table 1 Summary of different clinical presentations, the causative chemotherapy and the imaging findings

From: Chemotherapy-related neurotoxicity in pediatric cancer patients: magnetic resonance imaging and clinical correlation

  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