Neoplastic meningitis: a guide to diagnosis and treatment

Neoplastic meningitis is a disease of the entire neuraxis and is pleomorphi c in its clinical presentation. Diagnosis is achieved by recognition of the clinical manifestations of neoplastic meningitis followed by neuroradiogra phy of the brain and spinal cord and examination of the cerebrospinal fluid . Treatment, if clinically warranted, includes irradiation of symptomatic o r bulky disease and intracerebrospinal fluid chemotherapy following an asse ssment of the extent of metastatic disease treatment is based on the result s of four randomized intracerebrospinal fluid chemotherapy trials. Curr Opi n Neurol 13:641-648. (C) 2000 Lippincott Williams & Wilkins.