A rare case of chemotherapy induced reversible cerebral vasoconstriction syndrome in a patient of acute lymphocytic leukemia

Abstract

Neurotoxic reactions of chemotherapy occur frequently and are often dose limiting side effects of chemotherapy. It is important to differentiate these various nonneoplastic effects from metastases, or sometimes even from each other, since the therapeutic approach differs accordingly. To arrive at a definitive and comprehensive diagnosis, the radiologist should integrate imaging findings, clinical signs, and laboratory results together. Here we present a unique case of chemotherapy induced reversible cerebral vasoconstriction syndrome in a 13-year-old patient of acute lymphoblastic leukemia.

MRI characteristics of chemotherapy-related central neurotoxicity: a pictorial review

“…Reversible cerebral vasoconstriction syndrome (RCVS): RCVS is a clinical and radiological presentation characterized by acute thunderclap headache and reversible vasoconstriction of cerebral arteries [ 13 ]. It is considered a rare condition that can occur as a side effect of certain chemotherapeutic agents, particularly cyclophosphamide [ 14 , 15 ]. The typical features of RCVS on magnetic resonance angiography (MRA) include diffuse multifocal cerebral vasoconstriction, sometimes resulting in a string-of-beads appearance and distal vascular pruning [ 16 ].…”

Reversible Cerebral Vasoconstriction Syndrome in Children and Adolescents: A Case Series and Literature Review

“…Furthermore, in retinoblastoma, the combined impact of effects related to the malignancy (paraneoplastic effects) and those resulting from radiation therapy can lead to a complex interplay that results in autonomic dysregulation. Endothelial dysfunction, which is attributed to the vasoactive effects of metanephrines produced by pheochromocytomas, is also a noteworthy factor [1,19].…”