Clinical Reasoning: A 50-year-old man with headache and cognitive decline

Ayush Batra*, Aaron Berkowitz

*Corresponding author for this work

Research output: Contribution to journalComment/debatepeer-review


A 50-year-old man presented with headache and cognitive decline 10 weeks after undergoing matched-donor peripheral blood stem cell transplantation for treatment of mixed-phenotype acute leukemia. His pretransplant treatment included systemic chemotherapy (cyclophosphamide, daunorubicin, vincristine, prednisone, l-asparaginase, dasatinib, and cytarabine), intrathecal chemotherapy (methotrexate), and total body irradiation. His posttransplant course had been complicated by cutaneous graft-vs-host disease. Over 1 month, he developed holocephalic, throbbing, temporal headache worse when standing and reported feeling confused. His family members reported progressively withdrawn affect, depressed mood, and decreased spontaneous activity. Before his illness, he worked in a cognitively demanding profession with no history of cognitive deficit.

Original languageEnglish (US)
Pages (from-to)e182-e186
Issue number24
StatePublished - Dec 15 2015

ASJC Scopus subject areas

  • Clinical Neurology

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