Space Occupying Lesions Flashcards
Space Occupying Lesion Presentation
New headache
- With focal neurological symptoms on non-focal neurological symptoms such as blackout, change in personality or memory
- Unexplained headache that becomes progressively severe
- Previous diagnosis of HIV or cancer
- New onset epilepsy
Space Occupying Lesion Headache
- Classic brain tumour headache (worst in morning, bending or vasalva) is not as common as tension or migraine type presentation
- Change in frequency or pattern of headache is cause for concern
- N/V may occur
- Change in behaviour
- Weakness ataxia or disturbance of gait, deficits of speech or vision, convulsions
Space Occupying Lesion If Raised ICP?
Always look for papilloedema
Space Occupying Lesion False Localising Signs
- Abducens nerve has long tutrtuous path
- Sympathetic nerves (Horner’s) have long path, however good for lateralising
Space Occupying Lesion Cerebellar
- Ataxia
- Intention tremor, leads to past pointing
- Dysdiadochokinesis
- Nystagmus
- If truncal ataxia worse when eyes closed, lesion is in dorsal columns not cerebellum,
- Cerebellar speech is staccato
- Acoustic neuroma, Friedrich’s ataxia, stroke, tumours…
Space Occupying Lesion Temporal Lobe
- Vague psychological problems
- Depersonalisation, emotional changes and disturbance of behaviour
- Temporal lobe epilepsy (smell, taste, sound and sight (e.g. deja vu))
- Dysphasia
- Visual field defects
- Other psychological problems
Space Occupying Lesion Frontal Lobe
- Anosmia, especially significant if unilateral
- Change in personality to indecency, indiscretion and dishonest
- Dysphasia if Broca’s are involved
- Contralateral hemiparesis
Space Occupying Lesion Parietal Lobe
- Very interesting neurological picture
- Hemisensory loss
- Decreased two point discrimination
- Astereognosis
- Extinction
- Sensory inattention
Space Occupying Lesion Occipital Lobe
- Lesion in front of optic chiasma will affect just one eye
- Lesion at chiasma will affect both
- Lesion behind chiasma will cause homonymous hemianopia
- Loss of visual cortex will lead to ignoring the affected area
Space Occupying Lesion Cerebellopontine Angle
- Acoustic neuroma is most common pathology
- Ipsilateral deafness, tinnitus, nystagmus, reduced corneal reflex
Space Occupying Lesion Corpus Callosum
- Rapid intellectual deterioration
- Focal signs of adjacent lobes
- Inability of left hand to carry out verbal commands
Space Occupying Lesion Midbrain
- Unequal pupils
- Inability to direct eyes up or down
- Amnesia for recent events, with confabulation
- Somnolence
Space Occupying Lesion Pituitary
-Can cause hemianopia, most obvious presenting features are usually endocrine effects
Space Occupying Lesion Ix
- Bloods
- MRI
- Biopsy
