By David Schiff, Santosh Kesari, Patrick Yung Chih Wen

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J Thorac Cardiovasc Surg 2001;121(6):1053–1057. 49. Chamberlain MC, Kormanik PA. Prognostic significance of 111indium–DTPA CSF flow studies in leptomeningeal metastases. Neurology 1996;46(6):1674–1677. 50. Schiff D, O’Neill BP, Suman VJ. Spinal epidural metastasis as the initial manifestation of malignancy: clinical features and diagnostic approach. Neurology 1997:49:452–456. 51. Posner J. Side effects of radiation therapy. In: Posner J, ed. Neurologic Complications of Cancer. Philadelphia: FA Davis; 1995.

Detection of brain metastases: comparison of contrast–enhanced MR with unenhanced MR and enhanced CT. AJNR 1990;11:785–791. 6. Ohmoto Y, Nishizaki T, Kajiwara K et al. Calcified metastatic brain tumor: two case reports. Neurol Med Chir (Tokyo) 2002;42(6): 264–267. 7. , Gonzalez RG. Imaging of cerebral metastases. Neurosurg Clin N Am 1996;7(3):393–423. 8. Ricke J, Baum K, Hosten N. Calcified brain metastases from ovarian carcinoma. Neuroradiology 1996;38(5):460–461. 9. Gaviani P, Mullins ME, Braga TA et al.

Radionuclide cisternography is often employed to assess the patency of the CSF flow prior to instillation of intrathecal chemotherapy in order to increase the likelihood that the therapeutic agent will reach the entire subarachnoid space (49). If a site of blockage is demonstrated, then focal irradiation can be administered to areas of bulky disease to re-establish CSF flow. 4. EPIDURAL SPINAL CORD COMPRESSION (ESCC) The incidence of clinically diagnosed ESCC in patients with systemic cancer is approximately 5%.

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