J Korean Pediatr Soc.  2003 Nov;46(11):1112-1117.

CNS Complications in Childhood Cancer

• Jeong YJ
• Seo YK
• Kim HS
• Kim JS
• Lee HJ

Abstract

PURPOSE
Recent advances in the methods of treating cancer in young patients have led to both an increased frequency of CNS complications as well as prolonged life expectancy. We intend to analyze the clinical aspects and laboratory findings of patients with CNS complications during and after treatment.
METHODS
We reviewed the medical records of 174 childhood cancer patients treated with chemotherapy admitted to the Dept. of Pediatrics, Keimyung University Dongsan Hospital, from January 1995 to November 2002. Among them, 15 cases with CNS complications were investigated in this study.
RESULTS
CNS abnormalities were found in 13 patients by CT or MRI during treatment such as leukoencephalopathy(n=7), mineralizing microangiopathy(n=4), brain infarction(n=3), intracranial hemorrhage(n=1), and hypoxic ischemic encephalopathy(n=1). It was found that two patients had two or more CNS abnormalities. Two patients who had no imaging abnormalities had convulsions, possibly after the addition of intrathecal methotrexate. The patients with intracranial hemorrhage and brain infarction had rapid and fatal clinical courses. The hypoxic ischemic encephalopathy following electrolyte imbalance completely recovered after correction of electrolyte.
CONCLUSION
The CNS complications that occur during and after chemotherapy influence prognoses significantly, and remain neurologic sequelae. Therefore early diagnosis and prophylaxis for CNS complications and regular physical examination of patients who have recieved cancer therapy are strongly recommended.

Keyword

CNS complication; Chemotherapy; Leukoencephalopathy; Mineralizing microangiopathy; Intracranial hemorrhage; Brain infarction; Hypoxic ischemic encephalopathy

MeSH Terms

Brain
Brain Infarction
Drug Therapy
Early Diagnosis
Humans
Hypoxia-Ischemia, Brain
Intracranial Hemorrhages
Leukoencephalopathies
Life Expectancy
Magnetic Resonance Imaging
Medical Records
Methotrexate
Pediatrics
Physical Examination
Prognosis
Seizures
Methotrexate