Elliott P, Ku N N, Werner M H
Department of Neurology, University of South Florida, H. Lee Moffitt Cancer Center, Tampa, USA.
J Neuroimaging. 1995 Oct;5(4):233-6. doi: 10.1111/jon199554233.
Neoplastic meningitis, an unusual complication of systemic cancer, is becoming more common as cancer patients live longer. Although leptomeningeal metastases from solid tumors are usually associated with multifocal neurological signs, the authors report on 4 patients who presented with normal findings on neurological examination. One man had severe headache and complex partial seizures. Magnetic resonance imaging (MRI) of the brain revealed gadolinium enhancement of multiple cranial nerves. Cerebrospinal fluid (CSF) cytology was positive for melanoma. One woman presented with severe migratory retroorbital headaches. MRIs of the brain with and without gadolinium appeared normal. CSF cytology was positive for pulmonary adenocarcinoma. One man presented with morning headache, and a woman presented with back pain. Both had CSF cytologies positive for lymphoma. Neoplastic meningitis can occur without abnormalities on neurological or MRI examinations. Lumbar punctures should be performed on cancer patients with severe, unusual, or prolonged headaches.
肿瘤性脑膜炎是一种全身性癌症的罕见并发症，随着癌症患者寿命延长，其发病率正变得越来越高。虽然实体瘤的软脑膜转移通常与多灶性神经系统体征相关，但作者报告了4例神经系统检查结果正常的患者。一名男性有严重头痛和复杂部分性癫痫发作。脑部磁共振成像（MRI）显示多条颅神经钆增强。脑脊液（CSF）细胞学检查黑色素瘤呈阳性。一名女性出现严重的游走性眶后头痛。有钆和无钆的脑部MRI均显示正常。CSF细胞学检查肺腺癌呈阳性。一名男性出现晨起头痛，一名女性出现背痛。两人的CSF细胞学检查淋巴瘤均呈阳性。肿瘤性脑膜炎可在神经系统或MRI检查无异常的情况下发生。对于有严重、异常或持续性头痛的癌症患者，应进行腰椎穿刺。
