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NEUROLOGY 1986;36:1437
© 1986 American Academy of Neurology

Supraophthalmic intracarotid infusion of BCNU for malignant glioma

Sun-Hoo Foo, In-Sup Choi, Alejandro Berenstein, Arlene Wise, Joseph Ransohoff, Maxim Koslow, Ajax George, Joseph Lin, Irwin Feigin, Gleb Budzilovich, Mark Kupersmith, Richard Hanson, Steve Lequerica, Slobodan Aleksic and Irvin Kricheff

Departments of Neurology (Drs. Foo, Hanson, Lequerica, and Kupersmith), Neurosurgery (Drs. Ransohoff, Koslow, and Wise), Neuroradiology (Drs. Choi, Berenstein, George, Lin, and Kricheff), and Neuropathology (Drs. Feigin, Budzilovich, and Aleksic), New York University Medical Center, New York, NY.

We treated five patients with 11 supraophthalmic infusions of BCNU at 200 mg/m2 every 2 months. All three patients with residual tumors showed marked CT response after one infusion. Two patients with bilateral tumors had no response on the contralateral side. All four evaluable cases showed evidence of BCNU neurotoxicity. CT findings superficially resembled tumor recurrence, but white matter changes, nonspecific gyral enhancement, and delayed calcification were more indicative of neurotoxicity. There were no procedure-related complications. One autopsy suggested that direct parenchymal damage might be responsible for delayed neurotoxicity. Supraophthalmic BCNU infusion, at this dosage, is too toxic for cerebral tissue.

Address correspondence and reprint requests to Dr. Foo, Department of Neurology, New York University Medical Center, 650 1st Avenue, New York, NY 10016.

Supported in part by grant * NIH U-OCA36014.

Presented in part at the thirty-seventh annual meeting of the American Academy of Neurology, Dallas, TX, April 1985.

Accepted for publication March 18,1986.






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