Hypoglycorrhachia with Meningeal Carcinomatosis

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Abstract
Hypoglycorrhachia occurred in 2 patients with meningeal carcinomatosis, proven in a patient with malignant melanoma by autopsy and suggested in another patient with breast carcinoma by a positive CSF cytology and absence of central nervous system infection. Frequency with which hypoglycorrhachia is associated with diffuse involvement of the meninges by various disease processes has been pointed out, and the importance of obtaining a CSF sugar and cytology in those patients with undiagnosed central nervous system disturbances has been emphasized. The mechanism by which hypoglycorrhachia occurs in meningeal carcinomatosis is obscure. From review of available experimental data in meningeal carcinomatosis and analogous studies of hypoglycorrhachia in various infectious meningitides, it is suggested that the major mechanism of hypoglycorrhachia is a decreased rate of entry of glucose into the CSF rather than an increased rate of consumption of sugar by tumor cells.