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Images in Neurology
March 2010

Papilledema as the Sole Magnetic Resonance Imaging Finding in Leptomeningeal Metastasis

Author Affiliations

Author Affiliations: Toronto Western Hospital, University Health Network and Division of Neurology, University of Toronto, Toronto, Ontario, Canada.

Arch Neurol. 2010;67(3):362-363. doi:10.1001/archneurol.2010.15

A 54-year-old woman had headache and blurred vision for 2 months. Her medical history was significant for treated adenocarcinoma of the lung 5 years earlier. Her symptoms had worsened despite the treatment of associated elevated blood pressure. Examination revealed bilateral optic disc swelling. The sole finding on gadolinium-enhanced magnetic resonance imaging was a protrusion of the optic disc into the globe, which was more pronounced on the left (Figure 1). Spinal fluid examination revealed an opening pressure of 650 mm of cerebrospinal fluid and cytological analysis revealed adenocarcinoma of the lung. A follow-up computed tomographic image of the brain obtained 1 month later revealed bilateral protrusion of the optic disc into the globe (Figure 2). Given the poor prognosis of the patient's condition, she chose a palliative treatment focused on pain control.

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