Space Occupying Lesions Flashcards
Space occupying lesion signs
Headache worse on waking/ lying/ leaning forwards/ coughing Vomiting Papilloedema Decreased GCS Seizures (often focal) Developing focal neurology Subtle personality change
Space occupying lesion causes
Tumour Aneurysm Abscess/ Cyst Chronic subdural haematoma Granuloma
Space occupying lesion tests
CT ± MRI (good for posterior fossa mass)
Biopsy
Brain tumour management
Remove if possible
Gliomas debulked and chemo/radio to finish
Ventriculo-peritoneal shunt if hydrocephalus
Treat headache (codeine 60mg/4h)
Seizure prophylaxis if possible but often fails
Cerebral oedema management
Dexamethasone 4mg/8h PO
Mannitol if ICP acutely up
3rd ventricle colloid cyst signs
Present in adult life Amnesia, headache Blunted consciousness, dim vision Incontinence Bilateral parasthesia, weak legs, drop attacks
3rd ventricle colloid cyst treatment
Excision
Ventriculo-peritoneal shunt
Idiopathic intracranial hypertension presentation
Presents as if mass but none is found
Most commonly female, obese, in 20s
Papilloedema usually
Idiopathic intracranial hypertension management
Weight loss
Acetazolamide or topiramate (CA inhibitor actions) or loop diuretics
Prednisolone 40mg/24h PO
Optic nerve sheath fenestration or lumbar-peritoneal shunt if drugs fail
Temporal lobe mass signs
Dysphasia
Contralateral homonymous hemianopia
Amnesia
Odd inexplicable phenomena
Frontal lobe mass signs
Personality change
Executive dysfunction
Broca/ slight Wernicke’s problems
Hemiparesis
Parietal lobe mass signs
Hemisensory loss
Sensory inattention
Dysphasia
Touch issues (can’t recognise object by touch, worse 2-point discrimination)
Occipital lobe mass signs
Contralateral visual field defects
Polyopia
Palinopsia
Cerebellum mass signs
DANISH Dysdiadochokinesia + dysmetria Ataxia Nystagmus Inattention Slurred speech Hypotonia
Cerebellopontine angle mass signs
Ipsilateral deafness
Nystagmus
Ipsilateral cerebellar signs
Papilloedema
