Intracranial Hemorrhage Following Intrathecal Methotrexate Therapy for Acute Lymphoblastic Leukaemia.

Background: Acute toxic leukoencephalopathy following intrathecal methotrexate administration is well documented but intracranial haemorrhage is extremely rare. Case Characteristics: A 2½-year-old girl with acute lymphoblastic leukemia developed sudden onset neurological deterioration following intrathecal methotrexate. Observations: Computed tomography scan of brain demonstrated intraventricular and subarachnoid hemorrhage. Outcome: Child improved gradually on conservative management. Follow-up neuroimaging showed resolution of hemorrhage. Message: Intracranial haemorrhage is a rare but serious complication of intrathecal methotrexate.