Methotrexate-induced leukoencephalopathy

Case contributed by Dr Tomás Moliné


10-year-old female with acute lymphoblastic leukemia who had just finished the third cycle of intrathecal administration of methotrexate, presented with acute onset of right hemiparesis.

Patient Data

Age: 10 years old
Gender: Female

There are focal and symmetrical regions of restricted diffusion on DWI images and ADC maps, seen on both centrum semiovale and splenium of corpus callosum. T2-weighted images show high signal intensity, while FLAIR shows mild ring hyperintensity. After gadolinium injection there is no enhancement of these lesions.

Case Discussion

Clinical evolution and imaging findings suggest the presence of acute methotrexate-induced neurotoxicity.

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Case information

rID: 27698
Published: 26th Feb 2014
Last edited: 16th Jul 2018
Inclusion in quiz mode: Included

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