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Neurological presentations in the cancer patient

Department of Diagnostic Radiology, Royal Marsden Hospital, Downs Road, Sutton, Surrey SM2 5PT, UK

Summary

• Neurological presentations are increasingly frequent and clinically challenging problems in the cancer patient.
  
• Clinical information is vital for appropriate selection of radiological investigation.
  
• MRI is the most sensitive investigation for brain metastases.
  
• MRI for suspected epidural cord compression should include the whole spine.
  
• Craniospinal meningeal metastatic disease results in symptoms and signs that cannot be attributed to a single anatomical site.
  
• The brachial plexus is most commonly involved by superior sulcus lung tumours or recurrent breast carcinoma.
  
• The lumbosacral plexus is usually involved by bony deposits.
  
• Cranial neuropathy can result from bony metastatis in the skull base, or meningeal metastatic disease.