Leptomeningeal enhancement

Last revised by Andrew Murphy on 14 Jun 2022

Citation, DOI, disclosures and article data

Citation:

Salam H, Murphy A, Macori F, et al. Leptomeningeal enhancement. Reference article, Radiopaedia.org (Accessed on 09 Dec 2023) https://doi.org/10.53347/rID-9702

DOI:

https://doi.org/10.53347/rID-9702

Permalink:

https://radiopaedia.org/articles/9702?iframe=true

rID:

9702

Article created:

12 May 2010, Hani Makky Al Salam

Disclosures:

At the time the article was created Hani Makky Al Salam had no recorded disclosures.

View Hani Makky Al Salam's current disclosures

Last revised:

14 Jun 2022, Andrew Murphy ◉

Disclosures:

At the time the article was last revised Andrew Murphy had no recorded disclosures.

View Andrew Murphy's current disclosures

Revisions:

24 times, by 19 contributors - see full revision history and disclosures

Systems:

Central Nervous System, Oncology

Sections:

Gamuts

Tags:

oncology, refs

Synonyms:

Causes of leptomeningeal enhancement

Leptomeningeal enhancement refers to a diffuse or focal gyriform or serpentine enhancement that can be seen in the following conditions:

Diffuse

meningitis
- pyogenic meningitis
- viral meningitis
- tuberculous meningitis (can also be focal)
- CNS cryptococcal infection
- coccidioidal meningitis (can also be focal)
- primary amoebic meningoencephalitis
encephalitis
tumors
- primary
  - diffuse leptomeningeal glioneuronal tumor
- secondary
  - leptomeningeal carcinomatosis (e.g. from carcinoma of breast or lung, melanoma, ependymoma)
  - m eningeal melanomatosis
hemorrhage (e.g. post-subarachnoid)
post uncomplicated lumbar puncture (rare, less than 5%) ²
granulomatous conditions
- neurosarcoidosis (can also be focal)
post-operative (late finding)
post-traumatic (late finding)

Focal

leptomeningeal carcinomatosis (e.g. from carcinoma of breast or lung, melanoma)
post-ictal hyperemia
infarction: subjacent acute (leptomeningeal collaterals) or subacute
lymphoma
meningitis (e.g. tuberculous)
encephalitis
neurosarcoidosis
postoperative scar
vasculitis
- neurosyphilis
Sturge-Weber syndrome

Terminology

The enhancement of the brain surface is known as pial or pial-arachnoid enhancement and often referred to as leptomeningeal enhancement ³.

Conversely, as the thin arachnoid membrane is attached to the inner surface of the dura mater, the pachymeningeal pattern of enhancement can also be described as a dural-arachnoid enhancement ³.