05-02-2008, 07:53 AM
Bbbbbbbbbb
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for TH..:)...enjoy - kuku
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05-02-2008, 01:08 PM
TH
I am surprised you did not face this question while doing neurology question from Harrison. This is from Harrison only. Harrison's self assessment and board review- 15Th edition I guess.. Anyways seems like nobody else is interested in replying. Lemme put the answer.. Here you go......... The answer is E. (Chap. 370) The typical symptoms of neoplastic meningitis include headache, confusion, radiculopathy, and cranial nerve abnormalities in patients with a variety of tumors, including non-Hodgkin™s lymphoma, leukemia, melanoma, breast cancer, lung cancer, and stomach cancer. Given these symptoms, especially with a negative CT, MRI, or both, the diagnosis of leptomeningeal metastases from breast cancer is quite likely. A single lumbar puncture is a relatively insensitive test; repeat examinations of CSF are often required to establish the diagnosis of cancer that has spread to the meninges. Especially in cases where the cancer cells are œcaked onto the inferior portion of the brain, eradication by chemotherapy alone (usually methotrexate, thiotepa, or cytosine arabinoside) is difficult, and radiation therapy should be administered as well. |
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