Meningitis revealing pancreatic carcinoma

Meningeal carcinomatosis is an uncommon metastatic complication of systemic solid tumors. The diagnosis is based on the presence of malignant cells in the cerebrospinal fluid. The sensibility of cerebrospinal fluid testing in detecting the neoplastic cells improves when repeating lumbar punctures. Magnetic resonance imaging could help in establishing the diagnosis. The prognosis of carcinomatous meningitis is poor, especially when the primitive neoplasm is initially unknown. We report the case of a patient presenting with sudden bilateral visual decrease, headaches, and vomiting. Signs of meningeal irritation were found. Cerebrospinal fluid analysis showed malignant cells consistent with an adenocarcinoma. Abdominal echography and MRI concluded in a nodule of the cephalic portion of the pancreas. Carcinomatous meningitis rarely complicates pancreatic cancers

Susac's syndrome

We describe a 25-year-old woman that presented with frequent rotational dizziness, visual loss of the right eye one month later, and unilateral deafness one year after. After 2 years, she presented with a right hemiparesis and deafness greater for low frequency tones. Magnetic resonance imaging with angiography of the brain showed constriction in the first segment of the cerebral anterior artery diagnosed as Susac's syndrome