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Malignant meningitis presenting as pseudotumor cerebri

R M Ahmed1, G M Halmagyi

  • 1Department of Neurology, Royal Prince Alfred Hospital, Sydney, Australia. rebekahahmed@gmail.com

Journal of the Neurological Sciences
|April 13, 2013
PubMed

Insights

Malignant leptomeningitis and pachymeningitis can mimic pseudotumor cerebri. This occurs due to venous hypertension caused by tumor infiltration of sinuses, leading to increased intracranial pressure.

Area of Science:

  • Neurology
  • Oncology
  • Neurosurgery

Background:

  • Malignant leptomeningitis is a known cause of pseudotumor cerebri.
  • The mechanism involves infiltration of arachnoid villi and superior sagittal sinus obstruction.

Observation:

  • Malignant pachymeningitis can also present as pseudotumor cerebri.
  • This is likely due to cerebral venous hypertension from transverse sinus compression by tumor.

Findings:

  • Presents 3 cases of pseudotumor cerebri secondary to leptomeningeal or pachymeningeal metastases.
  • Demonstrates that dural metastases can cause venous outflow obstruction.

Implications:

  • Highlights a rare cause of secondary pseudotumor cerebri.
  • Emphasizes the importance of considering neoplastic meningitis in the differential diagnosis of idiopathic intracranial hypertension.
  • Discusses diagnostic and therapeutic strategies for this condition.

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