4. Space occupying lesion, raised ICP and brain tumours Flashcards
What is the different between primary and secondary brain tumours
primary usually arise from the intracranial structures such as meninges (meningioma) or glial cells (gliomas or astrocytomas)
Secondary arise from primary tumours usually arising from bronchus, breast, stomach, prostate, thyroid or kidneys
Space occupying lesions in the brain:
what infections can cause SOL
brain abscess
subdural empyema
granuloma (eg TB)
Parasitic
Space occupying lesions in the brain:
what vascular causes can cause SOL
any haemorrhage (extradural, subdural, subarachnoid, parenchymal
cavernoma (cluster of abnormal blood vessels) or vascular malformations
brain infarction (stroke)
what may cause hydrocephalus (accumulation of CSF)
tumours, cysts, intraventricular haemorrhage
Meningitis, sub-arachnoid haemorrhage
choroid plexus papilloma (rare)
Presentation of tumours, note the symptoms are due to raised ICP
What are the general common symptoms
headache, vomiting, blurred vision, deterioration of consciousness levels
Bradycardia, hypertension, Papilloedema
If a patient has a tumour in the frontal lobe, what symptoms would they present with
weakness, dysphasia, personality changes, dementia
If a patient has a tumour in the parietal lobe, what symptoms would they present with
sensory symptoms, dressing apraxia, visual field defects
If a patient has a tumour in the temporal lobe, what symptoms would they present with
dysphasia and visual field defects
If a patient has a tumour in the occipital lobe, what symptoms would they present with
visual field issues
If a patient has a tumour in the posterior fossa, what symptoms would they present with
dysmetria (lack of co-ordination), gait ataxia, cranial nerve palsy, tremors, nystagmus
Symptoms of neurological deficit is due to the compression or damage of adjacent structures. What is pronator drift and what does it show
when pt raises both arms horizontally with palms facing upwards, when they close their eyes one arm lowers or pronates (normally both should stay up) which indicates paresis
If the brain is irritated what kind of seizures can occur
focal seizure
general tonic clonic seizure
irritation of meninges can cause headache
What is the normal ICP in adults and at what point does it become pathological
less than 15mmHg in adults
pathological is when it is above 20 mmgHg
how is ICP different in children compared to adults
children have lower ICP and can be negative in newborn
how does ICP change when you sneeze or cough
it can go up to 75 at times