Intracerebral hematoma as a complication of intrathecal methotrexate administration

AbstractNeurotoxicity of methotrexate is a well‐documented issue, but development of an intracerebral hematoma following administration of intrathecal methotrexate is an extremely rare entity. A 6‐year‐old male with the diagnosis of non‐Hodgkin lymphoma was put on a treatment regimen, including intrathecal methotrexate. Six days following the last intrathecal methotrexate administration, the patient developed a deteriorating state of consciousness. There was no history of trauma. Coagulation studies and platelet count were normal. Magnetic resonance imaging of the brain demonstrated a large left frontoparietal hematoma. Intracerebral hematoma may be a very rare, but serious, complication of intrathecal methotrexate administration. Pediatr Blood Cancer 2008;50:152–154. © 2006 Wiley‐Liss, Inc.