Neoplastic meningitis - Revision history

Rossdonaldson1: /* Evaluation */

2021-11-27T06:00:27Z

Evaluation

← Older revision		Revision as of 06:00, 27 November 2021
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	==Evaluation==		==Evaluation==
			[[File:Meningeosis carcinomatosa bei Mamma-Ca - fokal - MRT T1 KM axial.jpg\|thumb\|Meningeal carcinomatosis on contrast-enhanced axial T1-weighted MRI.]]
	===Workup===		===Workup===
	*CT brain is not sensitive or specific, may show intracranial mass		*CT brain is not sensitive or specific, may show intracranial mass

Rossdonaldson1 at 05:25, 27 November 2021

2021-11-27T05:25:04Z

← Older revision		Revision as of 05:25, 27 November 2021
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	*Batool A, Kasi A. Leptomeningeal Carcinomatosis. [Updated 2020 Apr 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499862/		*Batool A, Kasi A. Leptomeningeal Carcinomatosis. [Updated 2020 Apr 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499862/
	*Cooney DR, Cooney NL. Meningeal carcinomatosis diagnosed during stroke evaluation in the emergency department. Int J Emerg Med. 2011;4:52. Published 2011 Aug 9. doi:10.1186/1865-1380-4-52		*Cooney DR, Cooney NL. Meningeal carcinomatosis diagnosed during stroke evaluation in the emergency department. Int J Emerg Med. 2011;4:52. Published 2011 Aug 9. doi:10.1186/1865-1380-4-52

			[[Category:Neurology]]

Rossdonaldson1: /* Differential Diagnosis */

2020-12-12T10:29:58Z

Differential Diagnosis

← Older revision		Revision as of 10:29, 12 December 2020
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	==Differential Diagnosis==		==Differential Diagnosis==
	*[[Meningitis]] (bacterial, fungal, viral)		{{Headache DDX}}
	*[[Encephalitis]]
	*Brain and Spinal metastasis

	==Evaluation==		==Evaluation==

Rossdonaldson1: /* References */

2020-12-12T10:29:02Z

References

← Older revision		Revision as of 10:29, 12 December 2020
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	==References==		==References==
	<references/>		<references/>
			*Shin Ahn, Kyung Soo Lim, "Three Cases of Neoplastic Meningitis Initially Diagnosed with Infectious Meningitis in Emergency Department", Case Reports in Emergency Medicine, vol. 2013, Article ID 561475, 4 pages, 2013.
			*Batool A, Kasi A. Leptomeningeal Carcinomatosis. [Updated 2020 Apr 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499862/
			*Cooney DR, Cooney NL. Meningeal carcinomatosis diagnosed during stroke evaluation in the emergency department. Int J Emerg Med. 2011;4:52. Published 2011 Aug 9. doi:10.1186/1865-1380-4-52

Rossdonaldson1: /* References */

2020-12-12T10:28:16Z

References

← Older revision		Revision as of 10:28, 12 December 2020
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	==References==		==References==
	<ref>Shin Ahn, Kyung Soo Lim, "Three Cases of Neoplastic Meningitis Initially Diagnosed with Infectious Meningitis in Emergency Department", Case Reports in Emergency Medicine, vol. 2013, Article ID 561475, 4 pages, 2013.</ref>

	<ref>Batool A, Kasi A. Leptomeningeal Carcinomatosis. [Updated 2020 Apr 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499862/</ref>

	~~<ref>Cooney DR, Cooney NL. Meningeal carcinomatosis diagnosed during stroke evaluation in the emergency department. Int J Emerg Med. 2011;4:52. Published 2011 Aug 9. doi:10.1186/1865-1380-4-52</ref>~~
	<references/>		<references/>

Brheinhart: Created page with "==Background== Also known as Leptomeningeal Carcinomatosis or leptomeningeal metastasis (LM) Uncommon and late complication of solid tumors and hematological cancers, approx..."

2020-11-21T05:13:09Z

Created page with "==Background== *Also known as Leptomeningeal Carcinomatosis or leptomeningeal metastasis (LM) *Uncommon and late complication of solid tumors and hematological cancers, approx..."

New page

==Background==
*Also known as Leptomeningeal Carcinomatosis or leptomeningeal metastasis (LM)
*Uncommon and late complication of solid tumors and hematological cancers, approximately 5-8% and 5-15% respectively
*Most common primary tumors associated with LM are breast, lung, and melanoma
*Commonly misdiagnosed due to symptoms mimicking infectious [[meningitis]] and chronic [[headache]]

===Pathophysiology===
*Multiple routes tumor cells can gain access to CSF
*Most commonly thought to be through hematogenous spread via arachnoid vessels or direct extension from brain parenchyma

==Clinical Features==
*Chronic [[headache]]
*[[Nausea and vomiting]]
*[[Fever]]
*Nuchal rigidity
*[[Altered mental status]]
*[[Seizure]]
*[[Spinal cord compression (non-traumatic)]]
**Limb weakness
**Dermatomal sensory loss
**Radicular pain
**Bladder and bowel dysfunction
*[[Cranial nerve abnormalities]]
**[[Diplopia]]
**Facial weakness
**Hearing loss
**[[Ataxia]]

==Differential Diagnosis==
*[[Meningitis]] (bacterial, fungal, viral)
*[[Encephalitis]]
*Brain and Spinal metastasis

==Evaluation==
===Workup===
*CT brain is not sensitive or specific, may show intracranial mass
*MRI brain and spine with contrast preferred (70% sensitivity, 77-100% specificity)
**Leptomeningeal enhancement
**[[Hydrocephalus]]
**Subependymal nodules or deposits
*[[Lumbar Puncture]]-mainly to rule out infectious etiology in ED
**Elevated opening pressure
**Glucose, protein, cell count and cytology can be abnormal
**Malignant cells on CSF smear

===Diagnosis===
*Leptomeningeal enhancement or lesions on MRI
*Malignant cells on CSF smear

==Management==
*Control seizures
**[[Benzodiazepines]]
**[[Antiepileptics]]
**Intubation if [[status epilepticus]]
*Pain management if headache, radicular pain
*Steroids may be indicated depending on severity of symptoms

==Disposition==
*Admit

==See Also==

==External Links==

==References==
<ref>Shin Ahn, Kyung Soo Lim, "Three Cases of Neoplastic Meningitis Initially Diagnosed with Infectious Meningitis in Emergency Department", Case Reports in Emergency Medicine, vol. 2013, Article ID 561475, 4 pages, 2013.</ref>

<ref>Batool A, Kasi A. Leptomeningeal Carcinomatosis. [Updated 2020 Apr 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499862/</ref>

<ref>Cooney DR, Cooney NL. Meningeal carcinomatosis diagnosed during stroke evaluation in the emergency department. Int J Emerg Med. 2011;4:52. Published 2011 Aug 9. doi:10.1186/1865-1380-4-52</ref>
<references/>

Neoplastic meningitis - Revision history

Rossdonaldson1: /* Evaluation */

Rossdonaldson1 at 05:25, 27 November 2021

Rossdonaldson1: /* Differential Diagnosis */

Rossdonaldson1: /* References */

Rossdonaldson1: /* References */

Brheinhart: Created page with "==Background== *Also known as Leptomeningeal Carcinomatosis or leptomeningeal metastasis (LM) *Uncommon and late complication of solid tumors and hematological cancers, approx..."

Brheinhart: Created page with "==Background== Also known as Leptomeningeal Carcinomatosis or leptomeningeal metastasis (LM) Uncommon and late complication of solid tumors and hematological cancers, approx..."