Summary
Retrospective evaluation of 120 patients treated for leptomeningeal metastases at the Hadassah Hebrew University Hospital disclosed 3 patients with spontaneous spinal subarachnoid hemorrhage (SAH) occurring in the absence of bleeding tendency. These patients are described in detail. A search of the English literature revealed only 2 additional cases. The primary neoplasm originated in the central nervous system in 4 of these 5 patients; a resection of an intraparenchymal posterior fossa tumor antedated the development of subarachnoid seeding in 3 of the 5 patients; SAH occurred in face of a negative CSF cytology and in the presence of macroscopic subarachnoid deposits that were diagnosed with the aid of neuroimaging techniques. It is suggested that spontaneous spinal SAH in a patient with a history of primary or secondary brain tumor and with no bleeding tendency indicates probable presence of macroscopic leptomeningeal deposits.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Iob I, Andrioli GC, Rigobello L, Salar G: An unusual onset of a spinal cord tumour: subarachnoid bleeding and papilloedema. Neurochirurgia (Stuttg) 23: 112–116, 1980
Djindjian M, Djindjian R, Houdart R, Hurth M: Subarachnoid hemorrhage due to intraspinal tumors. Surg Neurol 9: 223–229, 1978
Hawkins CP, Heron JR: Subarachnoid haemorrhage from spinal tumour (in the absence of spinal symptoms or signs). J Neurol Neurosurg Psychiat 51: 305–307, 1988 (letter)
Nassar SI, Correll JW: Subarachnoid haemorrhage due to spinal cord tumors. Neurology 18: 87–94, 1968
Runnels JB, Hanbery JW: Spontaneous subarachnoid hemorrhage associated with spinal cord tumor. J Neurosurg 39: 252–254, 1974
Papo I, Balint I, Slovik F, Scarpelli M, Ranaldi R: Subarachnoid haemorrhage due to widely metastatising malignant ependymoma. Neurochirurgia (Stuttg) 28: 243–245, 1985
Tarlov IM, Keener EB: Subarachnoid hemorrhage and tumor implants from spinal sarcoma in an infant. Neurology 3: 384–390, 1953
Pfeffer MR, Wigoda M, Siegal T: Leptomeningeal metastases —treatment results in 98 consecutive patients. Isr J Med Sci 24: 611–618, 1988
Rappaport ZH, Constantini S, Siegal T, Shuger L: Intramedullary fibrosarcoma of the cervicomedullary junction: a case report. Neurosurgery 21: 551–553, 1987
Scott EW, Cazenave CR, Virapongse C: Spinal Subarachnoid hematoma complicating lumbar puncture: diagnosis and management. Neurosurgery 25: 287–293, 1989
Caroscio JT, Brannan T, Budabin M, Huang YP, Yahr MD: Subarachnoid hemorrhage secondary to spinal arteriovenous malformation and aneurism. Arch Neurol 37: 101–103, 1980
Van Hille PT, Abbott RJ, Cameron MM, Hollan IM, Loizou LA: Recurrent spontaneous subarachnoid haemorrhage due to spinal haemangioblastoma. J Neurol Neurosurg Psychiat 50: 639–640, 1987 (letter)
Bryan P: CSF seeding of intra-cranial tumors: a study of 96 cases. Clin Radiol 25: 355–360, 1974
Mirimanoff RO, Choi NC: The risk of intradural spinal metastases in patients with brain metastases from bronchogenic carcinomas. Int J Radiat Oncol Biol Phys 12: 2131–2136, 1986
Mirimanoff RO, Choi NC: Intradural spinal metastases in patients with posterior fossa brain metastases from various primary cancers. Oncology 44: 232–236, 1987
Perrin RG, Livingston KE, Aarabi B: Intradural extramedullary spinal metastases. A report of 10 cases. J Neurosurg 56: 835–837, 1982
Siegal T, Pfeffer MR, Catane R, Sulkes A, Gomori M, Fuks Z: Successful chemotherapy of recurrent intracranial germinoma with spinal metastases. Neurology 33: 631–633, 1983
Wasserstrom WR, Glass P, Posner JB: Diagnosis and treatment of leptomeningeal metastases from solid tumors: experience with 90 patients. Cancer 49: 759–772, 1982
Siegal T, Sandbank U, Gabizon A, Siegal T, Mizrachi R, Ben-David E, Catane R: Alteration of the blood-brain-CSF barrier in experimental meningeal carcinomatosis. J Neuro-Oncol 4: 233–242, 1987
Jinkins JR: Current neuroradiological investigation of spontaneous hemorrhage into the craniospinal axis. Neurosurgery 18: 664–674, 1986
Rodesch G, Van Bogaert P, Mavroudakis N, Parizel PM, Martin JJ, Segebarth C, Van Vyve M, Baleriaux D, Hildebrand J: Neuroradiologic findings in leptomeningeal carcinomatosis: the value of gadolinium-enhanced MRI. Neuroradiology 32: 26–32, 1990
Scotti G, Filizzolo F, Scialfa G, Tampieri D, Versari P: Repeated subarachnoid hemorrhages from a cervical meningioma. Case report. J Neurosurg 66: 779–781, 1987
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Lossos, A., Siegal, T. Spinal subarachnoid hermorrhage associated with leptomeningeal metastases. J Neuro-Oncol 12, 167–171 (1992). https://doi.org/10.1007/BF00172668
Issue Date:
DOI: https://doi.org/10.1007/BF00172668