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Chemotherapy-induced CNS toxicity has been observed with increasing frequency. However, relevant systematic imaging studies have not been published. These authors reviewed the current literature and identified 27 cases of patients with a clinically distinct syndrome of delayed leukoencephalopathy with stroke-like presentations following chemotherapy. Methotrexate was the chemotherapeutic agent used in 19 cases; the others had received 5-fluorouracil, capecitabine, or carmofur.
Almost all patients presented clinically with focal neurologic deficits, cerebellar dysfunction, and brainstem signs after receiving systemic or intrathecal chemotherapy. Symptom onset usually occurred within hours to several days after drug administration. MRI finding…