New-generation tyrosine kinase inhibitor-associated asymptomatic cerebrovascular stenosis: two illustrative cases.
Akihiro HirayamaTakatoshi SorimachiKazuma YokotaHideaki ShigematsuKittipong SrivatanakulMitsunori MatsumaePublished in: Acta neurochirurgica (2021)
New-generation tyrosine kinase inhibitors (TKIs), nilotinib and ponatinib, for chronic myelogenous leukemia (CML) have been reported to cause symptomatic cerebral ischemia. Herein, we report two patients with asymptomatic cerebral artery stenosis associated with these TKIs, as a previously unreported finding. Both patients were in their 40 s and administered new-generation TKIs without vascular risk factors. New-generation TKIs for CML can cause major cerebrovascular stenosis without any symptoms. Examining the neck and intracranial arteries using magnetic resonance angiography and carotid ultrasonography may prevent future cerebral infarctions associated with these TKIs.
Keyphrases
- cerebral ischemia
- subarachnoid hemorrhage
- chronic myeloid leukemia
- magnetic resonance
- risk factors
- end stage renal disease
- brain injury
- ejection fraction
- blood brain barrier
- newly diagnosed
- computed tomography
- chronic kidney disease
- magnetic resonance imaging
- prognostic factors
- bone marrow
- acute myeloid leukemia
- patient reported outcomes
- physical activity
- depressive symptoms
- sleep quality
- cerebral blood flow