Intracranial Tumours and other SOLs (2)

Question 1

What are some of the SOLs that can occur?

What are the types of intracranial tumours?

Answer 1

➊ • Tumours - 30% are metastatic, commonly from lung, breast, kidney, skin
• Other SOLs – Aneurysm, Abscess, Chronic subdural haematoma, Granuloma, Cyst

➋ • Benign – Meningioma
• Malignant – Glioma – 3 subtypes, from most to least malignant are:
‣ Glioblastoma
‣ Oligodendroglioma
‣ Ependymoma
• Pituitary Tumours – Occurs just below Optic chiasm
• Acoustic Neuroma (Vestibular Schwannoma) – Occurs at Cerebellopontine angle

Question 2

How does it present?

How is it investigated?

Answer 2

➊ • Raised ICP – Headache, Papilloedema, N+V
• Seizures – SOL needs to be excluded in all adult-onset seizures
• Evolving focal neurological symptoms
• Personality change – Irritability, Lack of initiative, Socially inappropriate behaviour

➋ • MRI
• Biopsy

N.B. Avoid LP before imaging due to risk of coning