MediAI

 Leptomeningeal Carcinomatosis from Gastric Adenocarcinoma: A Rare Culprit of Rapid Cognitive Decline in the Elderly Abstract: A 72-year-old male presenting with acute confusion, subacute fatigue, and focal neurological symptoms was ultimately diagnosed with leptomeningeal carcinomatosis secondary to metastatic gastric adenocarcinoma. This case illustrates the necessity of a broad and evolving differential diagnosis for rapidly progressing neurocognitive decline in older adults, especially when initial findings are inconclusive. It also highlights the critical importance of meticulous diagnostic scrutiny of minor imaging abnormalities and cerebrospinal fluid (CSF) cytology. Introduction Acute cognitive decline in elderly patients demands a rapid, yet comprehensive, diagnostic approach. Differential diagnoses span from infectious and metabolic etiologies to structural, neoplastic, autoimmune, and prion-related conditions. Leptomeningeal carcinomatosis (LMC), a rare and devastating...