Leptomeningeal Disease

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Leptomeningeal Disease Morris D. Groves, MD, JD Neurosurgery Clinics Volume 22, Issue 1, Pages 67-78 (January 2011) DOI: 10.1016/j.nec.2010.08.006 Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig. 1 Axial T1 contrast-enhanced MRI of the brain in a 44-year-old woman with metastatic melanoma and positive cytology for malignant cells. Image (arrow) shows subtle linear contrast enhancement along a sulcus in the right frontal lobe. Neurosurgery Clinics 2011 22, 67-78DOI: (10.1016/j.nec.2010.08.006) Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig. 2 Axial T1-weighted contrast-enhanced MRI of the brain in a 62-year-old woman with breast cancer and positive cytology for malignant cells. Image (arrow) shows prominent enhancement along the cerebellar folia, typical of LMD. This patient had a pronounced response, lasting more than 5 months, to single-agent intrathecal methotrexate. Neurosurgery Clinics 2011 22, 67-78DOI: (10.1016/j.nec.2010.08.006) Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig. 3 Sagittal T1 contrast-enhanced MRI of the lumbosacral spine in a 50-year-old woman with breast cancer and CSF cytology positive for malignant cells. Image (arrow) shows shaggy contrast enhancement along the nerve roots of the cauda equina, typical of extensive LMD. Neurosurgery Clinics 2011 22, 67-78DOI: (10.1016/j.nec.2010.08.006) Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig. 4 (A) Sagittal contrast-enhanced MRI of the thoracic spine in a 64-year-old man with non–small cell cancer and malignant cells in the CSF. Image reveals an area of contrast enhancement on the surface of the midthoracic spinal cord. (B) Axial contrast-enhanced MRI of the thoracic spine through the area of enhancement on image (A) showing enhancement on the right dorsolateral surface of the spinal cord, and enhancement along the adjacent thoracic spinal nerve root. Neurosurgery Clinics 2011 22, 67-78DOI: (10.1016/j.nec.2010.08.006) Copyright © 2011 Elsevier Inc. Terms and Conditions