Leptomeningeal metastases happen when cancer cells spread to the membranes surrounding the brain and spinal cord. This is an advanced cancer complication and is almost always symptomatic by the time it is detectable. It would be exceptionally rare as an incidental finding in an asymptomatic person. An MRI may show changes in the meninges that could be consistent with leptomeningeal involvement. Identifying leptomeningeal spread early may allow for prompt treatment to help manage neurological symptoms. MRI with contrast is the preferred modality for assessing leptomeningeal disease, offering the clearest visualisation of meningeal enhancement.
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