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Widespread intracerebral metastases from prostate adenocarcinoma
  1. Devin Dean Mackay1,
  2. Eli Louis Diamond2,
  3. Joshua P Klein1,3
  1. 1Department of Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA
  2. 2Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
  3. 3Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA
  1. Correspondence to Dr Devin Dean Mackay, Brigham and Women's Hospital, Neurology, Boston, Massachusetts 02115, USA; devindmackay{at}gmail.com

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A 62-year-old man with prostate cancer and pulmonary metastases presented with a partial-onset seizure, involving a forced leftward head deviation and tonic limb posturing. He complained of no other symptoms except for diplopia. On examination, there was mild bilateral papilloedema, bilaterally limited ocular abduction, left-sided ataxia and bilateral extensor plantar responses. His medical history included two previous cerebellar infarctions, presumed to be due to cancer-related hypercoagulability and a completely resected cutaneous melanoma.

MR scan of the brain showed multiple cystic and nodular enhancing intraparenchymal lesions, some containing blood …

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