Summary
The angiographic findings in a case of metastatic meningeal carcinomatosis and a case of primary meningeal sarcomatosis are presented. The presence of focal arterial narrowing at the base of the brain and/or over the cerebral convexities, with or without a communicating hydrocephalus, may be the important clues to a diagnosis of diffuse meningeal involvement by tumor. In a patient who presents with bizarre and poorly localizing signs and symptoms, when the cerebrospinal fluid analysis does not fully support a diagnosis of meningitis or subarachnoid hemorrhage, and when there is nothing in the history to suggest drug abuse or a systemic collagen disease, the angiographic findings may point to an unexpected diffuse meningeal tumor.
Résumé
Les auteurs rapportent les données angiographiques dans lun cas de carcinomatose méningée métastatique et dans un cas de sarcomatose méningée primitive. La présence de sténoses artérielles localisées à la base du cerveau et/ou au niveau des convexités cérébrales avec ou sans hydrocéphalie communicante peuvent représenter des signes importants en faveur d'un envahissement tumoral méningé diffus. Chez un malade présentant une symptomatologie atypique et mal localisée, lorsque l'examen du liquide céphalo-rachidien ne parle pas franchement en faveur d'une méningite ou d'une hémorragie méningée et lorsque l'anamnèse n'évoque aucune intoxication exogène ni collagénose, les données angiographiques peuvent faire découvrir une tumeur méningée diffuse.
Zusammenfassung
In der vorliegenden Arbeit werden die angiographischen Befunde eines Falles einer metastatischen meningealen Karzinomatose und eines Falles einer primären meningealen Sarkomatose geschildert. Dabei läßt sich besonders die umschriebene arterielle Gefäßeinengung an der Basis des Gehirns und/oder über den Konvexitäten beobachten. Dieser Befund kann mit einem Hydrocephalus communicans kombiniert sein. Wenn bei einem Patienten merkwürdige und schlecht lokalisierbare neurologische Symptome vorliegen, wenn durch die Liquoruntersuchung die Diagnose einer Meningitis oder einer Subarachnoidalblutung nicht gesichert werden kann und wenn bei dem Patienten auch kein Drogen-Abusus besteht, ist bei den beschriebenen angiographischen Veränderungen an eine diffuse meningeale Tumorabsiedlung zu denken.
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This study was supported in part by a Special Fellowship in Neuroradiology (R.E.L.), 5 F11 NS02476-02, from the National Institute of Neurological Diseases and Stroke.
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Latchaw, R.E., Gabrielsen, T.O. & Seeger, J.F. Cerebral angiography in meningeal sarcomatosis and carcinomatosis. Neuroradiology 8, 131–139 (1974). https://doi.org/10.1007/BF00341592
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DOI: https://doi.org/10.1007/BF00341592