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Myelopathy after intrathecal chemotherapy. A case report with unique magnetic resonance imaging changes
Author(s) -
McLean Donald R.,
Clink Hugh M.,
Ernst Peter,
Coates Robert,
Zuheir Al Kawi M.,
Bohlega Saeed,
Omer Salah
Publication year - 1994
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19940615)73:12<3037::aid-cncr2820731223>3.0.co;2-6
Subject(s) - medicine , spinal cord , magnetic resonance imaging , myelopathy , paraplegia , cord , radiology , chemotherapy , surgery , psychiatry
Background. Paraplegia caused by intrathecal chemotherapy has no known pathognomonic features and is a diagnosis of exclusion. Methods. The authors reported the clinical and neuroimaging findings in one patient with this syndrome. Results. The patient had severe paraplegia with urinary retention and impaired pain and touch sensation below T‐10 with sparing of proprioception and vibration sense. Magnetic resonance imaging (MRI) scan showed diminished intensity throughout the central cervical spinal cord. Post‐gadopentetate dimeglumine enhancement was scattered throughout the cervical spinal cord and in two areas of the dorsal spinal cord. Axial views of the cervical spinal cord showed that this enhancement was limited to the lateral columns. Conclusions. The MRI in myelopathy due to intrathecal chemotherapy may show a unique pattern of post‐gadopentetate dimeglumine enhancement limited to the lateral columns of the spinal cord. However, two recently encountered patients with the same syndrome did not show similar changes. Cancer 1994; 73:3037–40.