Neoplastic meningitis: investigations

Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .

Neoplastic meningitis: investigations. Pleocytosis: in about 60% of cases, Raised protein: in 80% of cases. Fully referenced neurology checklist.

Cerebrospinal fluid (CSF): routine tests

  • Pleocytosis: in about 60% of cases
  • Raised protein: in 80% of cases
  • Reduced glucose: in 55% of cases
  • High CSF opening pressure: in 57% of cases
  • Cytology-negative: in about 40-50% of cases
  • Flow cytometry

CSF tumour markers

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Measures to improve CSF yield

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Contrast magnetic resonance imaging (MRI) brain and spine

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Radionuclide studies: features

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Meningeal biopsy

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Synonyms

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References

  1. Gleissner B, Chamberlain MC. Neoplastic meningitis. Lancet Neurol 2006; 5:443-452.
  2. Chamberlain MC. Neoplastic meningitis. Oncologist 2008; 13: 967-977.
  3. Milburn-McNally P, Michael B, Moxham N, Fletcher N, Crooks D. How to do it: how to get the most out of cerebrospinal fluid cytology. Pract Neurol 2012; 12:241-243.
  4. Liu X, Tan C, Zhu Y, Li S, Lai H, Deng F, Chen L. Teaching NeuroImage: Bloomy rind sign of leptomeningeal carcinomatosis. Neurology 2023; 101:e99-e100.
  5. Shaik RS, Yareeda S, Reddy S, Srivastava MK, Uppin MS, Sagi P. "Bloomy rind on cheese sign" - a radiological biomarker of leptomeningeal metastasis. Ann Indian Acad Neurol 2025; 28:432-434.
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