Abstract
Eight patients with meningeal seeding by carcinoma or lymphomas were treated with intravenous (i.v.) and/or intrathecal (i.th.) Methotrexate (MTX). Seven patients received additional craniospinal irradiation and in all seven a fatal encephalopathy developed. On the bases of clinical and morphological findings we identified an acute and a delayed form of encephalopathy and concluded that the concurrent administration of Methotrexate and of craniospinal irradiation increases considerably the risk of brain damage.
MeSH terms
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Adult
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Aged
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Brain Diseases / chemically induced*
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Brain Diseases / diagnosis
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Brain Diseases / etiology
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Brain Edema / chemically induced
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Breast Neoplasms / drug therapy
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Breast Neoplasms / therapy
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Child, Preschool
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Combined Modality Therapy
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Cranial Irradiation / adverse effects
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Demyelinating Diseases
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Diagnosis, Differential
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Female
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Gastrointestinal Diseases / chemically induced
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Humans
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Injections, Intravenous
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Injections, Spinal
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Lymphoma / drug therapy
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Lymphoma / therapy
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Male
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Meningeal Neoplasms / drug therapy*
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Meningeal Neoplasms / radiotherapy
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Meningeal Neoplasms / secondary
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Mental Disorders / diagnosis
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Methotrexate / administration & dosage
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Methotrexate / adverse effects*
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Methotrexate / therapeutic use
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Middle Aged
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Necrosis