Differential Diagnosis for Leptomeningeal Enhancement Rare Causes
- Single Most Likely Diagnosis
- Meningitis (infectious or inflammatory): This is the most common cause of leptomeningeal enhancement, and it can be due to various pathogens, including bacteria, viruses, or fungi, as well as non-infectious inflammatory conditions.
- Other Likely Diagnoses
- Leptomeningeal metastases: Cancer cells can spread to the leptomeninges, causing enhancement on imaging studies. This is a common cause of leptomeningeal enhancement in patients with a history of cancer.
- Sarcoidosis: This is a systemic inflammatory disease that can affect the central nervous system, including the leptomeninges, and cause enhancement on imaging studies.
- Neurosyphilis: This is a rare cause of leptomeningeal enhancement, but it can occur in patients with syphilis, especially in the tertiary stage.
- Do Not Miss Diagnoses
- Subarachnoid hemorrhage: Although this condition typically presents with acute symptoms, it can cause leptomeningeal enhancement on imaging studies, and missing this diagnosis can be catastrophic.
- CNS vasculitis: This is a rare but potentially life-threatening condition that can cause leptomeningeal enhancement, and it requires prompt diagnosis and treatment.
- Lyme disease: This is a rare cause of leptomeningeal enhancement, but it can occur in patients with Lyme disease, especially in the early stages.
- Rare Diagnoses
- Whipple disease: This is a rare systemic infectious disease that can affect the central nervous system, including the leptomeninges, and cause enhancement on imaging studies.
- Lymphomatoid granulomatosis: This is a rare condition that can cause leptomeningeal enhancement, and it is often associated with Epstein-Barr virus infection.
- Erdheim-Chester disease: This is a rare systemic histiocytic disorder that can affect the central nervous system, including the leptomeninges, and cause enhancement on imaging studies.