Acute Brain Arterial Infarctions Associated With Meningeal Carcinomatosis

Dusko Kozic 1 Jasmina Boban 1 Aleksandar Kopitovic 2
1Department of Radiology, University of Novi Sad Faculty of Medicine, Serbia
2Department of Neurology, University of Novi Sad Faculty of Medicine, Serbia

PURPOSE: To present a rare etiology of acute cerebral infarctions.

METHODS: Magnetic resonance imaging (MRI) was performed in a 63-year-old woman with acute onset of neurological symptoms, compatible with stroke.

RESULTS: Numerous lesions, hyperintense on FLAIR sequence, showing restricted difusion signal, were evident in the right frontal and contralateral parietal cortex and subcortex and in centrum semiovale bilaterally, consistent with acute infarctions. Postcontrast study revealed unequivocal leptomeningeal infiltration, most compatible with carcinomatosiss. Computerized tomograpgy of the thorax detected left upper lobe infitration, compatible with neoplastic process. Postmortem - autopsy analyses confirmed MRI findings.

CONCLUSION: It is well known that brain infarcts are not rarely seen in patients with neoplastic process, due to hypercoagulabitily in paraneoplastic syndrom. However, infarcts due to direct tumor-associated vessel invasion and vasculopathy with resultant ischemia should also be considered as a potential etiologic factor.

Dusko Kozic
Dusko Kozic