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Updated: Jul 13, 2026
Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
Primary diffuse leptomeningeal gliomatosis followed with serial magnetic resonance images
Satoshi Ishige1, Yasuo Iwadate, Hiroshi Ishikura
1Department of Neurological Surgery, Chiba University Graduate School of Medicine 1-8-1, Inohana, Chuo-ku, 260-8670 Chiba, Japan.
Abstract:
We report a case of primary diffuse leptomeningeal gliomatosis (PDLG) followed up with serial magnetic resonance images (MRI). A 45-year-old man manifested with bilateral abducens nerve palsy and meningisms. Repeated MRI revealed diffuse leptomeningeal enhancement throughout the central nervous system without intra-axial mass accompanied with the dilatation of ventricles and focally enlarged cerebral sulci. Brain biopsies showed a leptomeningeal gliomatosis. The MRI findings described here would contribute to the diagnosis of PDLG among other common diseases diffusely spreading along the leptomeningeal structures.
Insights
Primary diffuse leptomeningeal gliomatosis (PDLG) is a rare condition. Serial magnetic resonance imaging (MRI) aids in diagnosing PDLG by revealing characteristic leptomeningeal enhancement.
Area of Science:
- Neuro-oncology
- Neuroradiology
- Neuropathology
Background:
- Primary diffuse leptomeningeal gliomatosis (PDLG) is a rare neoplastic condition characterized by diffuse infiltration of the leptomeninges by glial tumor cells.
- Distinguishing PDLG from other leptomeningeal diseases can be challenging due to overlapping imaging features.
Observation:
- A 45-year-old male presented with bilateral abducens nerve palsy and meningeal signs.
- Serial magnetic resonance imaging (MRI) demonstrated diffuse leptomeningeal enhancement across the central nervous system.
- Imaging findings included ventricular dilatation and enlarged cerebral sulci, without an identifiable intra-axial mass.
Findings:
- Brain biopsy confirmed the diagnosis of leptomeningeal gliomatosis.
- The observed MRI patterns are indicative of PDLG.
Implications:
- Serial MRI is crucial for the diagnosis of PDLG.
- Recognizing these specific MRI findings can aid in differentiating PDLG from other conditions with diffuse leptomeningeal spread.
- This case highlights the importance of integrating clinical, radiological, and pathological findings for accurate PDLG diagnosis.
