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Intracranial Hemorrhage Following Intrathecal Methotrexate Therapy for Acute Lymphoblastic Leukaemia
Radheshyam Purkait1, Tuphan Kanti Dolai, Chinmoy Lath
1Departments of Pediatric Medicine and *Haematology, NRS Medical College and Hospital, Kolkata, West Bengal, India. Correspondence to: Dr Radheshyam Purkait, Department of Pediatric Medicine, NRS Medical College and Hospital, Kolkata 700 014, West Bengal, India. radheshyampurkait@gmail.com.
Background:
Acute toxic leukoencephalopathy following intrathecal methotrexate administration is well documented but intracranial haemorrhage is extremely rare.
Case Characteristics:
A 2-year-6 months old girl with acute lymphoblastic leukemia developed sudden onset neurological deterioration following intrathecal methotrexate.
Observations:
Computed tomography scan of brain demonstrated intraventricular and subarachnoid hemorrhage.
Outcome:
Child improved gradually on conservative management. Follow-up neuroimaging showed resolution of hemorrhage.
Message:
Intracranial haemorrhage is a rare but serious complication of intrathecal methotrexate.
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