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Cerebrospinal fluid exchange after intrathecal methotrexate overdose. A report of two cases
Author(s) -
Jakobson ÅM,
Kreuger A,
Mortimer Ö,
Henningsson S,
Seidel H,
Moe PJ
Publication year - 1992
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.1992.tb12244.x
Subject(s) - medicine , methotrexate , cerebrospinal fluid , anesthesia , neurotoxicity , intrathecal , lumbar puncture , accidental , perfusion , surgery , toxicity , physics , acoustics
Two patients aged 11 and four years, were accidentally given a 10‐fold overdose of intrathecal methotrexate while being treated for malignant disease. Neither patient developed any signs of neurotoxicity and exchange of lumbar cerebro‐spinal fluid was started 3 and 5 h later, respectively. In one of the patients, who received 120 mg of methotrexate intrathecally, 31% of the given dose was recovered during 2 h of cerebrospinal fluid exchange that was started 3 h after the accidental overdosage. No sequelae were observed in any of the patients. Cerebrospinal fluid exchange is safe and can be recommended in all cases of intrathecal methotrexate overdosage. Ventriculo‐cisternal perfusion is not necessary in cases of a 10‐fold overdose if the patient has no signs of acute neurotoxicity.