Subacute Methotrexate Encephalopathy Mimicking Ischemic Stroke With Dynamic Changes on Magnetic Resonance Imaging

Kei Yamanaka, Takuya Okata, Yoshiki Sambongi, Ikumi Yamanaka, Kazuki Tanimoto, Tetsuro Ago, Takanari Kitazono, Jiro Kitayama

Research output: Contribution to journalArticle

Abstract

We report a 35-year-old woman who suddenly developed left hemiparesis and dysarthria at 13 days after treatment with intrathecal and intravenous methotrexate for intravascular large B cell lymphoma with possible central nervous system infiltration. Seven hours after onset, she developed further right hemiparesis and aphasia. However, the majority of neurologic symptoms disappeared spontaneously and completely by 34 hours. We also recorded the dynamic progression and regression of abnormal signals in the bilateral corona radiata on diffusion-weighted imaging, in parallel with neurologic symptoms. The rapid reversal of MR abnormalities and neurologic symptoms allowed us to diagnose methotrexate encephalopathy, and exclude intravascular large B cell lymphoma recurrence and regular brain infarction. The case provides new data on the dynamic changes of abnormal signals on magnetic resonance imaging in methotrexate encephalopathy over a short recovery time.

Original languageEnglish
Pages (from-to)e233-e235
JournalJournal of Stroke and Cerebrovascular Diseases
Volume27
Issue number11
DOIs
Publication statusPublished - Nov 1 2018

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Neurologic Manifestations
Brain Ischemia
Methotrexate
Stroke
Magnetic Resonance Imaging
Brain Diseases
B-Cell Lymphoma
Paresis
Brain Infarction
Dysarthria
Aphasia
Central Nervous System
Recurrence
Therapeutics

All Science Journal Classification (ASJC) codes

  • Surgery
  • Rehabilitation
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

Cite this

Subacute Methotrexate Encephalopathy Mimicking Ischemic Stroke With Dynamic Changes on Magnetic Resonance Imaging. / Yamanaka, Kei; Okata, Takuya; Sambongi, Yoshiki; Yamanaka, Ikumi; Tanimoto, Kazuki; Ago, Tetsuro; Kitazono, Takanari; Kitayama, Jiro.

In: Journal of Stroke and Cerebrovascular Diseases, Vol. 27, No. 11, 01.11.2018, p. e233-e235.

Research output: Contribution to journalArticle

Yamanaka, Kei ; Okata, Takuya ; Sambongi, Yoshiki ; Yamanaka, Ikumi ; Tanimoto, Kazuki ; Ago, Tetsuro ; Kitazono, Takanari ; Kitayama, Jiro. / Subacute Methotrexate Encephalopathy Mimicking Ischemic Stroke With Dynamic Changes on Magnetic Resonance Imaging. In: Journal of Stroke and Cerebrovascular Diseases. 2018 ; Vol. 27, No. 11. pp. e233-e235.
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