Document Detail

Cortical blindness during chemotherapy: clinical, CT, and MR correlations.
MedLine Citation:
PMID:  2312856     Owner:  NLM     Status:  MEDLINE    
Two patients treated by chemotherapy for a non-Hodgkin malignant lymphoma developed focal neurological symptoms including disorientation, hemoplegia, and cortical blindness 5 and 15 days after the end of a polychemotherapy course, including methotrexate and vindesine. In both patients ECG and blood pressure were normal. Case 1 had a slight increase of protein level without cells on CSF examination and presented with a paralytic ileus. Case 2 developed an inappropriate antidiuretic hormone secretion (IADHS) syndrome. In both cases, noncontrast CT scans showed bilateral, symmetrical low density areas within the temporooccipital regions. Postcontrast CT images stressed major cortical and subcortical enhancement predominantly over the gray matter. In Case 2 the lesions also affected the right parietal lobe. Magnetic resonance scans 2-3 weeks after the onset of neurological symptoms demonstrated low intensity signal lesions on T1-weighted images and bright signal on T2-weighted images. In Case 1 the visual deficit failed to regress and in Case 2 the patient died 2 months later because of the natural evolution of her lymphoma. The clinical and radiological data suggested that a vascular ischemic process was responsible for the cerebral lesions in these two patients. As Vinca alkaloids and not methotrexate have been implicated as a cause of cortical blindness, and as our two patients presented signs of overdose of vindesine (paralytic ileus and IADHS), we suggest that the neurological and radiological abnormalities in our patients may have been due to neurotoxicity of vindesine.
F Heran; G Defer; P Brugieres; F Brenot; A Gaston; J D Degos
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of computer assisted tomography     Volume:  14     ISSN:  0363-8715     ISO Abbreviation:  J Comput Assist Tomogr     Publication Date:    1990 Mar-Apr
Date Detail:
Created Date:  1990-04-23     Completed Date:  1990-04-23     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7703942     Medline TA:  J Comput Assist Tomogr     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  262-6     Citation Subset:  IM    
Service de Neuroradiologie, Hopital Henri Mondor, Creteil, France.
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MeSH Terms
Blindness / etiology*
Brain Ischemia / chemically induced*,  complications,  diagnosis
Magnetic Resonance Imaging*
Middle Aged
Tomography, X-Ray Computed*
Vindesine / adverse effects*
Reg. No./Substance:

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