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  • Title: Neurotoxicity of intrathecal methotrexate: MR imaging findings.
    Author: Sandoval C, Kutscher M, Jayabose S, Tenner M.
    Journal: AJNR Am J Neuroradiol; 2003 Oct; 24(9):1887-90. PubMed ID: 14561622.
    Abstract:
    We report a case of intrathecal methotrexate neurotoxicity manifesting as left arm weakness and aphasia. Diagnostic imaging showed restricted diffusion and fluid-attenuated inversion recovery imaging findings were normal at presentation. Three weeks later, diffusion abnormalities resolved, and T2-weighted studies showed increased signal intensity of prolonged T2 changes in areas of prior restricted diffusion. We attribute the clinical and radiographic findings to cytotoxic edema secondary to intrathecal methotrexate.
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