Cerebrospinal fluid flow abnormalities in patients with neoplastic meningitis

Grossman, Stuart A.; Trump, Donald L.; Chen, David C. P.; Thompson, G. G.; Camargo, Edwaldo E.

doi:10.1016/0002-9343(82)90404-1

Cited by 146 publications

(67 citation statements)

References 23 publications

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“…Weakness is often expressed initially in the proximal muscle groups. 26 In contrast, Gilbert and co-workers reviewed 130 cases of epidural cord compression and concluded that the spinal cord symp toms were relatively symmetrical in the majority of cases. In the few cases with asymmetrical cord signs, careful neurologic examination revealed signs of bilateral cord di~ease.~'…”

Section: Discussionmentioning

confidence: 99%

Clinical features and natural history of intramedullary spinal cord metastasis

Grem¹,

Burgess²,

Trump³

1985

Cancer

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170

141

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Five cases of intramedullary spinal cord metastasis are presented and an additional 50 cases from the English language literature since 1960 are reviewed. Lung cancer and breast cancer were the most frequently occurring primary neoplasms, but a wide variety of solid tumors may cause intramedullary spinal cord metastasis. The presenting symptoms were pain and/or weakness. The neurologic status deteriorated rapidly in the majority of patients in a period to days to weeks. Progression to a cord hemisection syndrome or cord transection occurred in approximately half of the patients. The characteristic myelographic appearance of fusiform swelling of the cord was seen in one third of the patients, but the myelogram was normal in 42%. Plain radiographs of the spine showed no evidence of metastatic disease in three fourths of cases. The cerebrospinal fluid protein level was frequently elevated, but results of cytologic studies were usually negative. High-resolution computer-assisted tomographic scanning may show intramedullary metastases. Radiation therapy combined with corticosteroid administration offers the only effective palliation. The recognition of intramedullary spinal cord metastasis is an ominous finding. Intramedullary spinal cord metastasis generally occurred in the setting of widespread systemic and intracranial disease, but occasionally was the only site of relapse. More than 80% of patients died within 3 months. Heightened awareness of this entity may lead to early diagnosis at a stage when neurologic deficits are reversible and, it is hoped, more effective palliation can be achieved.

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Section: Discussionmentioning

confidence: 99%

Clinical features and natural history of intramedullary spinal cord metastasis

Grem¹,

Burgess²,

Trump³

1985

Cancer

Self Cite

170

141

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“…Abnormal CSF circulation has been demonstrated in 30%-70% of patients with NM, with blocks commonly occurring at the skull base, in the spinal canal, and over the cerebral convexities [46,49,50]. Patients with interruption of CSF flow demonstrated by radionuclide ventriculography were shown, in three clinical series, to have a shorter survival time than those with normal CSF flow [49,51,52].…”

Section: Neuroradiographic Studiesmentioning

confidence: 98%

Neoplastic Meningitis

2008

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After completing this course, the reader should be able to:1. Describe the epidemiology of leptomeningeal metastasis.2. Participate in the diagnosis of leptomeningeal metastasis. Engage in the treatment of leptomeningeal metastasis.This article is available for continuing medical education credit at CME.TheOncologist.com. CME CME ABSTRACTBackground: Neoplastic meningitis (NM) is a common problem in neuro-oncology, occurring in approximately 5% of all patients with cancer.Methods: Notwithstanding frequent focal signs and symptoms, NM is a disease affecting the entire neuraxis, and therefore staging and treatment need encompass all cerebrospinal fluid (CSF) compartments.Results: Central nervous system staging of NM includes contrast-enhanced cranial computerized tomography or magnetic resonance imaging (MR-Gd), contrast-enhanced spine magnetic resonance imaging or computerized tomographic myelography and radionuclide CSF flow study. Treatment of NM incorporates involved-field radiotherapy of bulky or

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“…Fifty to seventy percent of adults with neoplastic meningitis, including those with leukemia, have abnormalities in patterns of CSF flow at the time of presentation, and 111 In DTPA CSF flow study has proved to be more sensitive than either MRI with gadolinium or CT in detecting blocks and compartmentalization of CSF [6,7]. These findings have practical and theoretical ramifications for patients such as ours with overt meningeal leukemia.…”

Section: Discussionmentioning

confidence: 99%