Clinical Neurology and Neuroscience
Volume 1, Issue 2, May 2017, Pages: 34-37
Received: Jan. 24, 2017;
Accepted: Apr. 6, 2017;
Published: Apr. 30, 2017
Views 1707 Downloads 112
Selin Yetkinel, Department of Neurology, Agri State Hospital, Agri, Turkey
Basak Karakurum Goksel, Baskent University Faculty of Medicine, Department of Neurology, Adana Teaching and Medical Research Center, Adana, Turkey
Headache, the most common symptom of cerebral dysfunction caused by leptomeningeal carcinomatosis, may be the only symptom. The headache usually results from increased intracranial pressure. Brain metastasis of gastric cancer in particular is rarely encountered and leptomeningeal carcinomatosis (LMC) is even less common. Presentation with isolated headache is a very rare condition in patients with gastric carcinoma. This 48-year-old man was admitted to the neurology outpatient clinic with headache that was present for nearly one month. The pain was felt in entire head particularly in the occipital and neck regions. The nature of the pain was throbbing, which worsened in the morning while the patient was in supine position. His headache persisted for all day. There was no nausea and vomiting. Neurological examination was normal. Brain MRI (contrast-enhanced) demonstrated triventricular hydrocephaly with transependymal edema. MR angiography and venography were also normal. Lumbar puncture revealed high cerebrospinal fluid (CSF) pressure (320 cm H2O), normal biochemistry except for mildly elevated protein, and unremarkable microbiological and pathological examination five days, and fundus examination revealed papilledema. Abdominal tomography demonstrated a focal area of increased gastric wall thickening. Result of endoscopic examination was reported as giant ulcer. PET showed increased FDG uptake in the gastric antrum. Gastric biopsy revealed diffuse carcinoma. Ventriculo-peritoneal shunt was performed for hydrocephalus. His treatment continued at medical oncology department. We reported this case since clinical presentation with isolated headache in the patients with gastric carcinoma is a rare condition.
Basak Karakurum Goksel,
Ring Cell Gastric Cancer Presenting with Headache, Clinical Neurology and Neuroscience.
Vol. 1, No. 2,
2017, pp. 34-37.
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