Aminoff's Neurology and General Medicine (Fifth Edition)
2014, Pages 539-562
Chapter 26 - Metastatic Disease and the Nervous System
The incidence of nervous system metastases is increasing due to improved treatment of primary systemic malignancies. The entire nervous system is susceptible to metastatic disease, typically occurring in the presence of disseminated disease. Metastases to the nervous system are usually symptomatic and have significant morbidity and mortality. Metastatic neurologic involvement is diagnosed in 45 percent of patients with malignant disease, and the brain is the most common site affected. Metastases vary depending on tumor type. Lung cancer and melanoma often metastasize to the brain; prostate and breast carcinomas lead to skull base and spine metastases; and breast, lung and hematologic malignancies are frequent causes of leptomeningeal metastases. Early diagnosis and treatment may prevent disability in these patients, who have limited life expectancy. In this chapter, common presenting features, diagnosis, contemporary treatment and prognosis of metastatic disease are discussed.
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