Cerebral venous and sinus thrombosis with cerebrospinal fluid circulation block after the first methotrexate administration by lumbar puncture

• Published in: Neuroradiology Vol. 44; no. 11; pp. 929 - 932
• Main Authors: BIENFAIT, H. P, GIJTENBEEK, J. M. M, VAN DEN BENT, M. J, DE BRUIN, H. G, VOOGT, P. J, PILLAY, M
• Format: Journal Article
• Language: English
• Published: Berlin Springer 01-11-2002; Springer Nature B.V
• Subjects: Antimetabolites, Antineoplastic - administration & dosage; Antimetabolites, Antineoplastic - adverse effects; Biological and medical sciences; Cerebrospinal Fluid - physiology; Dexamethasone - administration & dosage; Drug Therapy, Combination; Drug toxicity and drugs side effects treatment; Glucocorticoids - administration & dosage; Humans; Leukemia, Lymphocytic, Chronic, B-Cell - drug therapy; Magnetic Resonance Imaging; Male; Medical sciences; Methotrexate - administration & dosage; Methotrexate - adverse effects; Middle Aged; Pharmacology. Drug treatments; Sagittal Sinus Thrombosis - diagnosis; Sagittal Sinus Thrombosis - etiology; Spinal Puncture - adverse effects; Toxicity: nervous system and muscle; Antineoplastic agent; Lumbar spine; Toxicity; Leukemia; Cardiovascular disease; Route of administration; Venous disease; Vascular disease; Cerebral venous and sinus thrombosis (CVST); Lymphoproliferative syndrome; Small lymphocytic lymphoma/leukemia; Cranial venous sinus; Methotrexate; Cerebrovascular disease; Human; Nervous system diseases; Malignant hemopathy; Non Hodgkin lymphoma; Lymphocytic lymphoma; Thrombosis; Intrathecal administration; Lumbar puncture; Cerebral disorder; Case study; Central nervous system disease; Cisternography; Intrathecal methotrexate; Puncture; Cerebrospinal fluid block
• ISSN: 0028-3940; 1432-1920
• DOI: 10.1007/s00234-002-0854-3

We report a patient treated for small lymphocytic lymphoma/leukemia with cerebral venous and sinus thrombosis (CVST) after lumbar puncture with intrathecal administration of methotrexate (MTX). He also developed a cerebrospinal fluid flow block. This is the first report of an association between lumbar puncture and intrathecally administered MTX and the development of CVST. Intrathecal treatment in this patient was discontinued and he was successfully treated with high-dose low-molecular-weight heparin subcutaneously.