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Updated: May 7, 2026
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The Stroke Preclinical Assessment Network Multi-Laboratory Model of Thromboembolic Stroke with Thrombolysis: TE-MCAo
Published on: December 19, 2025
520
Methotrexate induced leucoencephalopathy: A stroke mimic.
Tushar D Gosavi1, Mohammed Tauqeer Ahmad, Lai-Heng Lee
1Department of Neurology, National Neuroscience Institute, Singapore.
Annals of Indian Academy of Neurology
|October 9, 2013
Summary
Recognizing stroke mimics is crucial to avoid unnecessary thrombolysis. A case study highlights methotrexate-induced stroke-like episodes in a leukemia patient, emphasizing careful diagnosis to prevent bleeding complications.
Area of Science:
- Neurology
- Hematology
- Oncology
Background:
- Thrombolysis for acute ischemic stroke is common within a 4.5-hour window.
- Accurate diagnosis is essential to prevent complications from treating stroke mimics.
Observation:
- A 17-year-old female with acute lymphoblastic leukemia experienced recurrent stroke-like episodes.
- These episodes coincided with chemotherapy involving intravenous and intrathecal methotrexate.
- Magnetic Resonance Imaging (MRI) showed changes consistent with acute ischemic stroke during these episodes.
Findings:
- The patient's neurological deficits and MRI findings resolved spontaneously after each episode.
- Discontinuation of methotrexate from the chemotherapy regimen prevented further stroke-like episodes.
Implications:
- Methotrexate can induce reversible stroke-like symptoms, mimicking acute ischemic stroke.
- This case underscores the importance of considering medication side effects in stroke mimic diagnosis.
- Avoiding specific chemotherapeutic agents like methotrexate can prevent iatrogenic neurological events in susceptible patients.
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