24. Signs of brain tumors Flashcards
General abt. symptoms of brain tumors
- Symptoms based on location and size, rather than histological type.
- Symptoms develops gradually (weeks-years)
- Symptoms can present acutely with hemorrhage or hydrocephalus
General symptoms of brain tumors
- Signs of increased ICP: headache, papilledema
- Brain shift: loss of consciousness , vomit, pupillary dilation
- Epilepsy: focal or generalized
Monroe-Kellie principle
Total vol. of brain tissue, CSF and blood is constant, because vol. inside cranium is fixed. Increased vol. of one leads to decr. of another
Supratentorial brain tumors location
- frontal lobe
- occipital lobe
- parietal lobe
- temporal lobe
- hypothalamus
- pituitary
- corpus callosum
Tumor frontal lobe
- Contralat. face, arm or leg weakness
- Expressive asphasia
- Personality change
- Dementia
Tumor occipital lobe
Visual field defect (homonymous hemianopia)
Tumor corpus callosum
Disconnection syndrome
Tumor in parietal lobe
- Disturbed sensation (touch, passive movement, two-point discrimination)
- Visual field defect (Homonymous inferior quadrantanopia)
- Right-left confusion, finger agnosia
- Sensory or motor neglect
Tumor in hypothalamus/pituitary
Endocrine dysfunction
Types of supratentorial tumors
- Meningioma = most common benign
- Glioblastoma = most common malignant
-
Metastasis: result in perifocal edema
(Small cell lung carcinoma, breast, kidney, pancreas)
Infratentorial tumors location
Midbrain/brainstem or cerebellum
Midbrain/brain stem tumor signs and symptoms
- cranial nerve lesion III-XII
- long tract sign - motor and sensory spasticity, hyperreflexia, and abnormal reflexes such as Babinski or Hoffman’s sign
- altered conciousness
- tremor
- impaired eye movements
- pupillary abnormalities
- vomiting
Tumor in cerebellum signs and symptoms
- Ataxic gait
- Tremor
- Dysmetria
- Dysarthria
- Nystagmus
Types of tumors in posterior fossa
- Pilocytic astrocytoma = cerebellum: most common benign
- Medulloblastoma (embryonal tumor) = cerebellar vermis: most common malignant
- Ependymoma (infratentorial type) = 4th ventricle
Intracranial hypertension syndrome
Caused by all tumors when reaching a certain size. Non-specific symptoms:
- Headache (worst supine, in the morning)
- Nausea, vomiting
- Loss of conciousness (decreases with increasing ICP)
- Cushings phenomenon (incr. in SBP, decr.. in DBP, HR, RR)
- Bilateral **abducens n. palsy **with double vision (compression of n. at skull base)
- Papilledema
