Papilledema as the Sole Magnetic Resonance Imaging Finding in Leptomeningeal Metastasis

Malignant meningitis presenting as pseudotumor cerebri

“…While it is well recognized that these patients can have hydrocephalus without papilledema, only a few have been noted to have papilledema without hydrocephalus-i.e. the clinical syndrome of PTC [11,17,21]. Here we show that secondary malignant invasion not only of the leptomeninges, but also of the pachymeninges, can cause PTC.…”

“…what we deduce to have been PTC [10,11,17]. However an in-depth review of some major published series of malignant leptomeningitis suggests that many cases of PTC are unrecognized [9,19,29].…”

“…In patients with primary or secondary malignant leptomeningitis ICH is usually due to, or at least attributed to, communicating hydrocephalus [8,9]. However we have found single case reports of patients with malignant leptomeningitis [10,11] or pachymeningitis (dural metastases) [12,13] who have ICH with papilledema but without hydrocephalus, but are not recognized as having the clinical syndrome of PTC. Here we report 3 cases with PTC due to metastatic malignant meningitis, 2 with leptomeningitis and one with pachymeningitis, in order to show that PTC as well as communicating hydrocephalus can be the presentation of ICH in patients with malignant meningitis.…”

A Case of Leptomeningeal Carcinomatosis Manifesting With Vertigo in the Setting of Intracranial Hypertension

“…This mechanism could possibly explain the presentation in our patient, given the fact that there were no changes observed in his neuroimaging studies that could explain his symptoms. Elevated ICP due to LMC can manifest in multiple ways; pseudotumor cerebri [19][20][21] and intracranial hypertension with hydrocephalus [22] have been reported in the literature.…”