RT Journal
A1 Mitus A
T1 DExamethasone
JF American Journal of Diseases of Children
JO American Journal of Diseases of Children
YR 1969
FD March 1
VO 117
IS 3
SP 307
OP 312
DO 10.1001/archpedi.1969.02100030309009
UL http://dx.doi.org/10.1001/archpedi.1969.02100030309009
AB IN SPITE of the progress in treatment of childhood leukemia, the control of meningeal leukemia remains a problem. The blood brain barrier prevents the penetration of the antileukemic drugs into the central nervous system (CNS)1-5 and the anatomical geography of the cerebral gyri renders leukemic cells inaccessible to drugs injected into the subarachnoid space. When the antileukemic drug is given intrathecally, it often fails to eradicate malignant cells completely, as shown by the frequent reappearance of blasts in the cerebrospinal fluid (CSF) and by the persistence at postmortem examination of leukemic infiltrate in the CNS.6The clinical picture of meningeal leukemia varies in the extent and severity of the neurological symptoms and signs. Headache, nausea and vomiting, drowsiness, and irritability are the most frequent symptoms; papilledema, cranial nerve palsies, and separation of the cranial sutures are the most common signs. Headache when present can be of an extreme