Ni. Karabacak et al., ASSESSMENT OF BRAIN PERFUSION BY TC-99M-HMPAO SPECT IN AKINETIC MUTISM DUE TO HIGH-DOSE INTRAVENOUS METHOTREXATE THERAPY, Child's nervous system, 13(10), 1997, pp. 560-562
Chemotherapy of the central nervous system may cause neurotoxicity in
children with acute lymphocytic leukemia. We evaluated regional blood
flow in a 6-year-old child presenting with akinetic mutism, using Tc-9
9m-HMPAO single photon emission tomography (SPECT) following high-dose
intravenous methotrexate therapy. While findings in X-ray computerize
d tomography were decreased density in bilateral basal ganglia and tha
lamic nuclei with diffusely decreased attenuation of the periventricul
ar white matter, a global, frontal dominant profoundly abnormal perfus
ion pattern involving both gray and white matter was observed in the S
PECT study. Treatment of the central nervous system with high dose int
ravenous chemotherapy may cause profound abnormalities in white and gr
ay matter blood flow and early assessment of the neurotoxicity may be
identified by Tc-99m-HMPAO SPECT in the pediatric age group.