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Metastasis to the base of the skulk clinical findings in 43 patients

Departments of Neurology (Drs. Greenberg and Posner), Radiation Therapy (Drs. Vikram and Chu), and Diagnostic Radiology (Dr. Deck], Memorial Sloan-Kettering Cancer Center, and the Departments of Neurology and Radiology, Cornell University Medical College, New York, NY.

we studied 43 patients with metastases to the base of the skull to determine whether clinical symptoms localized the lesions accurately. We identified five clinical syndromes: orbital, parasellar, middle fossa, jugular foramen, and occipital condyle. The orbital and parasellar syndromes were characterized by frontal headache, diplopia, and first-division trigeminal sensory loss. Proptosis occurred with the orbital but not the parasellar syndrome. The middle-fossa syndrome was characterized by facial pain or numbness. The jugular foramen syndrome was characterized by hoarseness and dysphagia, with paralysis of the ninth through eleventh cranial nerves. The occipital condyle syndrome was characterized by unilateral occipital pain and unilateral tongue paralysis.

Address correspondence and reprint requests to Dr. Posner, 1275 York Avenue, New York, NY 10021

Presented in part at the thirty-first annual meeting of the American Academy of Neurology, Chicago, IL, April 1979.

Accepted for publication August 5, 1980.

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