Methotrexate neurotoxicity

  • Usually seen in intrathecal administration of high doses in children
  • MRI
    • bilateral T2 hyperintense centrum semiovale lesions with diffusion restriction
    • partial or totally reversible
    • also causes delayed leukoencephalopathy – confluent T2/FLAIR white matter hyperintensities
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de Oliveira, Arthur M., et al. “Imaging patterns of toxic and metabolic brain disorders.” Radiographics 39.6 (2019): 1672-1695.

Vázquez, Elida, et al. “Side effects of oncologic therapies in the pediatric central nervous system: update on neuroimaging findings.” Radiographics 31.4 (2011): 1123-1139.