Diffuse cerebral vasospasm with infarct after intrathecal cytarabine in childhood leukemia

Pediatr Int. 2014 Dec;56(6):921-924. doi: 10.1111/ped.12394.

Abstract

Although the varied neurotoxicity of intrathecal (IT) chemotherapy for treatment of childhood acute leukemia is well known, most are related to transient post-puncture headache, drug-induced arachnoiditis, or leukoencephalopathy after methotrexate or cytarabine. Cerebral vasospasm leading to acute infarct after IT chemotherapy is very uncommon in children. Reported herein is a rare case of diffuse cerebral vasospasm with subsequent cerebral infarct after IT cytarabine in a 7-year-old boy with acute lymphoblastic leukemia, who successfully recovered with supportive management, and a review of the literature.

Keywords: acute lymphoblastic leukemia; cerebral vasospasm; intrathecal cytarabine.

Publication types

  • Case Reports

MeSH terms

  • Antimetabolites, Antineoplastic / therapeutic use*
  • Cerebral Infarction / etiology*
  • Child
  • Cytarabine / therapeutic use*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy*
  • Vasospasm, Intracranial / etiology*

Substances

  • Antimetabolites, Antineoplastic
  • Cytarabine