Uldry P A, Teta D, Regli L
Service de Neurologie, Centre Hospitalier Universitaire Vandois, Lausanne.
Neurochirurgie. 1991;37(1):72-4.
A 60 year old white woman progressively developed radicular pain and weakness in both legs. A meningeal carcinomatosis was diagnosed, and an intrathecal chemotherapy with methotrexate (M.T.X.) was begun. A catheter was placed in the frontal horn of the right lateral ventricle. One month later, the patient progressively developed inattentiveness and confusion. The examination showed an abulic-hypokinetic syndrome, and a left hemiparesis. A C.T. scan showed a hypodensity in the frontal-lobe white matter on the right, with contrast enhancement surrounding the region of the catheter. Results of cytologic, bacterial and fungal studies of cerebrospinal fluid were negative. The catheter was removed. The patient was treated with prednisone and she improved. This complication is very rare, and is noticed in only 0.6% of patients who had intraventricular M.T.X. therapy. The cause of this syndrome is a displacement of the catheter into parenchyma. This syndrome is distinct from the other complications (meningoencephalitis, leukoencephalopathy, myelopathy).
一名60岁的白人女性逐渐出现双侧腿部神经根性疼痛和无力。诊断为脑膜癌病，并开始鞘内注射甲氨蝶呤（M.T.X.）化疗。在右侧侧脑室额角置入一根导管。一个月后，患者逐渐出现注意力不集中和意识模糊。检查显示为无动性缄默-运动不能综合征及左侧偏瘫。计算机断层扫描（C.T.）显示右侧额叶白质低密度影，导管周围区域有强化。脑脊液的细胞学、细菌学和真菌学检查结果均为阴性。取出导管。患者接受泼尼松治疗后病情好转。这种并发症非常罕见，在接受脑室内M.T.X.治疗的患者中仅0.6%会出现。该综合征的病因是导管移位至脑实质。此综合征与其他并发症（脑膜脑炎、白质脑病、脊髓病）不同。
