John Guirgis
	
                                                                                                            
Tanzania                                    	
                                    
 Case Report
                                                                        A Silent and Debilitating Case of Obstructing Hydrocephalus                                     
Author(s): Alex Zaharcu, Rohit Kumar, Mark Phillip Baker, John Guirgis, Furqan Haq and Nemer DabageAlex Zaharcu, Rohit Kumar, Mark Phillip Baker, John Guirgis, Furqan Haq and Nemer Dabage             
                                    
                                                                        
                             Background: Leptomeningeal metastases are complications of advanced cancer and have a scarce but often death-dealing incidence. Diagnosis often requires a good measure of suspicion and patients can present with a vast diversity of signs and symptoms.
Case presentation: A 76-year-old male who comes in with altered mental status of unknown etiology with past medical history significant for multiple types of cancer and recent travel to Vancouver. He was investigated by our internal medicine team for altered mental status, pulmonology for a possible pneumonia, neurology for possible HSV encephalitis vs. cranial metastases and infectious disease for a new onset rash on his torso.
Conclusion: Metastasis was diagnosed through spinal fluid cell analysis and patient was sent to hospice.
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