Brain metastases Flashcards
Which primary cancers most commonly metastasise to brain?
Lung
Breast
Melanoma
Colorectal
Renal cell carcinoma
What are the symptoms of brain mets?
Headache worse when lying flat
Nausea and vomiting
Reduced GCS
Seizures
Blurred vision
Focal neurological signs
Signs of ICP
Cushing triad
What is Cushing’s triad?
Hypertension
Bradycardia
Irregular respirations
What is the gold standard investigation for brain mets?
MRI head
What other investigations can be useful in the diagnosis of brain mets?
CT brain - less sensitive than MRI
PET scan - identify primary site of cancer if unknown
What is the management of brain mets?
Corticosteroids
Radiotherapy
Surgery - solitary metastases
Chemotherapy
What are the complications of brain mets?
Raised ICP
Neurological deficits
Seizures
Neurocognitive deficits
