Spinal subarachnoid hemorrhage associated with leptomeningeal metastases.
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.
Lossos
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Department of Neurology, Hadassah Hebrew University Hospital, Israel.
Siegal
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D000293:Adolescent; D001099:Arachnoid; D005260:Female; D006801:Humans; D008577:Meningeal Neoplasms / Q000150:complications / Q000556:secondary*; D008875:Middle Aged; D010841:Pia Mater; D012189:Retrospective Studies; D013345:Subarachnoid Hemorrhage / Q000150:complications*