Document Detail


Inadvertent intrathecal vincristine administration: a neurosurgical emergency. Case report.
MedLine Citation:
PMID:  17355029     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Vincristine has a high neurotoxicity level. If given intrathecally by accident, it can cause ascending radiculomyeloencephalopathy, which is almost always fatal. The authors report a rare case in which vincristine was accidentally injected intrathecally into a 32-year-old man. The patient, who had Burkitt lymphoma, was neurologically intact, and it is likely that his survival was made possible due to aggressive neurosurgical therapy. After immediate cerebrospinal fluid (CSF) aspiration, external ventricular and lumbar drains were placed for CSF irrigation, which was continued for 6 days. This CSF irrigation was combined with 1) the intrathecal administration of fresh-frozen plasma to bind the vincristine and 2) an intravenous antineurotoxic therapy involving pyridoxine, folic acid, and glutamic acid. The patient's first sensorimotor deficits occurred after 2 days, led to an incomplete sensorimotor dysfunction below T-9 within the next 17 days, but progressed no further. Supported by the scarce data culled from the reviewed literature, the authors hypothesize that prolonged CSF irrigation combined with antineurotoxic therapy contributed to the patient's satisfactory outcome. In conclusion, accidental intrathecal vincristine injection requires emergency and adequate neurosurgical therapy.
Authors:
Maher Qweider; Joachim M Gilsbach; Veit Rohde
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Journal of neurosurgery. Spine     Volume:  6     ISSN:  1547-5654     ISO Abbreviation:  -     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-03-14     Completed Date:  2007-04-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101223545     Medline TA:  J Neurosurg Spine     Country:  United States    
Other Details:
Languages:  eng     Pagination:  280-3     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, University Hospital Aachen, Germany. Maherqweider@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Antineoplastic Agents, Phytogenic / administration & dosage*,  poisoning*
Burkitt Lymphoma / drug therapy
Encephalomyelitis / chemically induced*,  therapy*
Humans
Injections, Spinal / adverse effects*
Magnetic Resonance Imaging
Male
Medication Errors
Vincristine / administration & dosage*,  poisoning*
Chemical
Reg. No./Substance:
0/Antineoplastic Agents, Phytogenic; 57-22-7/Vincristine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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