Etiologies of leptomeningeal enhancement include: infection (viral, bacterial, or fungal), sarcoid, or neoplastic (lymphoma or carcinomatous).
In this case patient had a spinal tap and CSF demonstrated: (reference range)
The patient was diagnosed with Cryptococcal meningitis. There was no known history of HIV. The patient was also found to have a small left PICA infarct likely secondary to vacuities/spasm.