Table 1.

Blood-Brain Barrier Disruption Treatment

Day	Treatment
Day 1, admission	History and physical examination
	Routine labs
	Neuroimaging
Days 2 and 3	BBBD treatment
	General anesthesia
	Antiepileptic drugs
	Transfemoral catheterization of carotid or vertebral artery
	25% warmed mannitol IA infusion over 30 seconds
	IV imaging agent
	Chemotherapy*
	IA methotrexate
	Brain imaging to document disruption
Day 4	Leucovorin rescue
	Discharge
Day 5	Granulocyte colony-stimulating factor

Abbreviations: BBBD, blood-brain barrier disruption; IA, intra-arterial; IV, intravenous.

^*Between 1982 and 1993, chemotherapy used in combination with methotrexate included etoposide (150 mg/m² IV days 1 and 2) or cyclophosphamide (15 mg/kg IV days 1 and 2) and procarbazine (100 mg orally days 3 through 16; 44 patients). Between 1994 and 2005, etoposide or etoposide phosphate (150 mg/m² IV days 1 and 2) and cyclophosphamide (500 mg/m² IV days 1 and 2) were used (105 patients). Granulocyte colony-stimulating factor was added in 1994. At that time, etoposide or etoposide phosphate replaced oral procarbazine.