鞘内注射甲氨蝶呤毒性导致广泛性脑水肿致脑死亡病例报告
Intrathecal Methotrexate Toxicity Resulting in Brain Death due to Generalized Cerebral Edema Case Report.
作者信息
Pang Haoming, Chan Julie L, Bannykh Serguei I, Gezalian Michael, Lahiri Shouri, Toossi Shahed, Ayodele Maranatha
机构信息
Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
出版信息
Neurohospitalist. 2022 Oct;12(4):697-701. doi: 10.1177/19418744221106313. Epub 2022 Jun 6.
Intrathecal methotrexate (IT MTX) resulting in severe adverse events including life-threatening cerebral edema is not well described. We report a rare case of death in a 37-year-old BRCA1+ woman with metastatic triple-negative breast cancer status post mastectomy following administration of IT MTX for leptomeningeal carcinomatosis. Within the 24 hours after intraoperative IT MTX delivery, she developed neurologically devastating diffuse cerebral edema leading to uncal and cerebellar tonsillar herniation. This case report highlights a rare but devastating side effect of IT MTX.
鞘内注射甲氨蝶呤（IT MTX）导致包括危及生命的脑水肿在内的严重不良事件的情况尚未得到充分描述。我们报告了一例罕见的死亡病例，患者为一名37岁的BRCA1阳性女性，患有转移性三阴性乳腺癌，在接受乳房切除术后，因柔脑膜癌病接受IT MTX治疗。在术中给予IT MTX后的24小时内，她出现了具有神经破坏性的弥漫性脑水肿，导致钩回和小脑扁桃体疝形成。本病例报告强调了IT MTX一种罕见但具有破坏性的副作用。
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