[Cerebral metastases and their revealing forms in a series of 156 cases. Contribution of cerebral scintigraphy to the diagnosis and indications for surgery].

This series of 156 cases of brain metastases collected over a period of 14 years may be divided up into 65 considered as multiple following further investigation and thus refused for surgery, and 91 considered as simple and operated on. Our conclusions are very similar to those presented recently to the French Society of Neurosurgery. Emphasis is however placed on the frequency of metastases which are the first sign of cancer and thus resemble a cerebral tumour. Postoperatively the primary tumour continues to develop for it is often not found. Even under these conditions, a single metastasis should lead to operation and it may be distinguished from multiple metastases by a brain scan together with angiography which often permit not only the diagnosis of malignant tumour but also its secondary nature. The scan was positive in 85% of our 78 cases including 20 gamma-encephalographies and 58 angioscans. The diagnosis of metastases was possible in only 57% where as other authors have accorded more specificity to this investigation.