Tumors that are more frequently metastasize to the meninges:
(1) breast cancer
(2) lung cancer
(3) malignant melanoma
(4) genitourinary carcinoma
(5) carcinoma of the head and neck
Clinical symptoms and symptoms:
(1) headache
(2) confusion, dementia, or mental status changes
(3) seizures
(4) hemiparesis
(5) diplopia (from cranial nerve dysfunction in CN III, IV and/or VI)
(6) sensory or motor loss in trigeminal distribution (CN V)
(7) cochlear dysfunction (CN VIII)
(8) optic neuropathy (CN II)
(9) motor weakness in the upper or lower extremities
(10) cauda equina syndrome
(11) dermatomal or segmental sensory loss or pain
(12) nuchal rigidity
Laboratory findings:
(1) increased opening pressure on CSF tap (> 200 mm H2O)
(2) increased CSF leukocytes (> 4 per µL)
(3) elevated CSF protein (> 50 mg/dL)
(4) decreased CSF glucose (< 60 mg/dL)
(5) positive CSF cytology (uncommon)
(6) positive meningeal biopsy
(7) positive PCR
Imaging findings:
(1) abnormal MRI with gadolinium enhancement
(2) abnormal CSF flow dynamics (using radionuclides such as 111-Indium-diethylenetriamine penta-acetic acid or 99-Technetium macro-aggregated albumin)
(3) presence of CNS parenchymal metastases
