Differential diagnosis of stroke: Subacute leukoencephalopathy following high-dose methotrexate therapy in a young patient with osteosarcoma

Abstract

Stroke is a critical emergency situation in neurological acute medical care, requiring quick assessment and decision as to when to apply thrombolysis. To avoid unnecessary thrombolytic treatment and potential complications it is mandatory to be aware of the possible differential diagnoses. We describe the case of a thirty-year-old man with a subacute leukoencephalopathy following high-dose methotrexate treatment which resembled a stroke in terms of clinical presentation and MR-tomography.

Keywords

• Stroke mimic
• Subacute leukoencephalopathy
• Methotrexate