PMC7752766_01
Leptomeningeal enhancement demonstrated on MRI with and without contrast of the brain and spinal cord. MRI brain axial image showing leptomeningeal enhancement of the posterior fossa and the visualized proximal spinal cord (A). Leptomeningeal enhancement was noted in sagittal images of the cervical spine (B), thoracic spine (C), and lumbar spine (D). Areas of hyperintensity are denoted by the red arrows.
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An MRI brain with and without contrast revealed increased leptomeningeal enhancement involving the posterior fossa and visualized proximal spinal cord (Figure 1A), concerning for tuberculosis, neurosarcoidosis, or CNS carcinomatosis. Given her reported thoracic back pain, a subsequent MRI of her total spine with and without contrast was performed which showed diffuse leptomeningeal enhancement of the cervical (Figure 1B), thoracic (Figure 1C) and lumbar spinal cord (Figure 1D), including the cauda equina, distal pons, medulla and basal cisterns.