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[Hemiplegia and contralateral multiple aseptic osteonecrosis]

A Saraux¹, C Guedes, B Jouppe

¹Service de Rhumatologie, CHU Morvan, Brest.

Revue Du Rhumatisme (Ed. Francaise : 1993)

|January 1, 1994

Summary

Acute myelogenous leukemia patients treated with chemotherapy and irradiation may develop cerebral radionecrosis and osteonecrosis. Corticosteroids may influence the development of osteonecrosis, particularly on the nonparalyzed side.

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Area of Science:

Neurology
Oncology
Radiology

Background:

A patient with acute myelogenous leukemia underwent treatment including chemotherapy, irradiation, and corticosteroid therapy.
This treatment regimen is standard for managing acute myelogenous leukemia.

Observation:

The patient developed cerebral radionecrosis, a serious complication affecting brain tissue due to radiation.
The cerebral radionecrosis resulted in hemiplegia, or paralysis on one side of the body.
Subsequently, multiple areas of osteonecrosis, or bone death, were observed on the side of the body opposite to the hemiplegia.

Findings:

Cerebral radionecrosis and subsequent hemiplegia were noted post-treatment for acute myelogenous leukemia.
Osteonecrosis developed in multiple foci, specifically on the nonparalyzed side of the patient.

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The occurrence of osteonecrosis exclusively on the nonparalyzed side suggests a potential protective mechanism related to hemiplegia.

Implications:

The findings suggest a potential link between hemiplegia and the prevention of osteonecrosis in patients treated for acute myelogenous leukemia.
Understanding these mechanisms could lead to targeted strategies for preventing or managing osteonecrosis in cancer survivors.
Further research is warranted to elucidate the specific pathophysiological pathways involved.