By David Schiff, Santosh Kesari, Patrick C. Y. Wen
Neuro-oncology has advanced considerably as a scientific and examine self-discipline during the last few a long time. Cancer Neurology in medical perform: Neurologic problems of melanoma and its therapy, moment Edition presents clinicians from quite a few backgrounds and degrees of teaching with a connection with support concentration the differential analysis, therapy technique, and administration plan for the melanoma sufferer with neurologic indicators and findings.
The quantity starts off with an outline of the sector of neuro-oncology and a evaluation of the function of neuroimaging within the prognosis of neuro-oncologic affliction. numerous chapters on interpretation and administration of universal neuro-oncologic indicators stick with. next sections include chapters at the direct and oblique neurologic issues of melanoma in addition to issues of remedy. the ultimate part specializes in the spectrum and administration of neurologic sickness in sufferers with melanoma of particular organs.
Cancer Neurology in medical perform: Neurologic problems of melanoma and its remedy, moment Edition is a vital new paintings that goals to develop and deepen the familiarity of clinicians with the variety and administration of neuro-oncologic ailments with the intention to increase the standard of deal with melanoma patients.
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Additional info for Cancer Neurology in Clinical Practice; Neurologic Complications of Cancer and Its Treatment
Imaging is a valuable adjunct to diagnosis when CSF cytology is negative or when lumbar puncture cannot be safely obtained. Imaging can also be helpful in choosing radiation therapy fields for bulky LM. Sagittal T1W images after gadolinium administration through the head (left) and upper spine (right). detection of leptomeningeal disease, showing hyperintensity in the subarachnoid spaces. Patchy enhancement of the leptomeninges is the most common MR finding. Occasionally, meningeal metastases invade the underlying parenchyma with parenchymal T2W hyperintensity, swelling, and contrast enhancement.
Conversely, prolonged or permanent focal deficits can occur in patients with brain tumors following seizures of focal onset (22,63). Similarly, prolonged or irreversible cognitive decline may occur following generalized seizures in brain tumor patients. Seizure-induced increases in intracranial pressure, disruption of the blood–brain barrier, and elevations in excitotoxic neurotransmitter levels superimposed upon pre-existing abnormalities in intracranial pressure, blood flow, and the peritumoral microenvironment may provide a physiologic explanation for these observations (64,65).
Contrast-enhanced CT is more sensitive than nonenhanced T1- and T2-weighted MR images, but inferior to contrast MR imaging. MR imaging with gadolinium is most commonly used to detect pachymeningeal and leptomeningeal metastases (Fig. 9), but FLAIR imaging is also quite sensitive in 26 Part II / Diagnostic Studies Fig. 9. Extensive leptomeningeal and pial enhancement over the surface of the brain and cervical cord can be seen with leptomeningeal metastasis. Imaging is a valuable adjunct to diagnosis when CSF cytology is negative or when lumbar puncture cannot be safely obtained.