Cancer. Cancer treatment.

SYMPTOMS AND SIGNS:
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Brain tumors present in two patterns, not necessarily mutually exclusive. One consists of nonfocal symptoms of increased intracranial pressure, such as headaches, nausea, vomiting, confusion, and lethargy. The other consists of symptoms or signs of focal brain dysfunction, such as hemianopia, hemiparesis, cranial nerve palsies, or focal seizures. Such signs of focal brain dysfunction may have convincing localizing value even before an image of the brain is made by computed tomography (CT) or magnetic resonance imaging (MRI). Some tumors that arise in neurologically “silent” areas, such as the parietal or frontal association cortices, may produce only nonfocal generalized symptoms of headache, confusion, behavioral change, or, eventually, a seizure, despite growing to a considerable size. Although the capacity to reach early diagnosis by CT or MRI has greatly reduced the numbers of patients in whom symptoms of increased intracranial pressure represent initial complaints, examples still remain, especially in association with fast-growing tumors and in children. The latter are particularly likely to have tumors in the posterior fossa that tend to obstruct spinal fluid pathways earlier than do supratentorial tumors. The tempo with which a brain tumor grows also influences the presenting symptoms. Despite the fixed space within the skull (once infantile sutures have closed), the human brain possesses a remarkable capacity to make room for a slowly growing tumor. Because of this, and even allowing for the relative rapidity of growth of aggressive brain tumors, such as glioblastomas, the patient usually appears better clinically than might be expected from the degree of abnormality seen on CT or MRI scan.

FOCAL CLINICAL MANIFESTATIONS OF BRAIN TUMORS

Frontal lobe

Generalized seizures

Focal motor seizures (contralateral)

Expressive aphasia (dominant side)

Behavioral changes

Dementia

Gait disorders, incontinence

Basal ganglia

Hemiparesis (contralateral)

Movement disorders rare

Parietal lobe

Receptive aphasia (dominant side)

Spatial disorientation (nondominant side)

Cortical sensory dysfunction (contralateral)

Hemianopia (contralateral)

Occipital lobe

Hemianopia (contralateral)

Visual disturbances (unformed)

Temporal lobe

Complex partial (psychomotor) seizures

Generalized seizures

Behavioral changes

Olfactory and complex visual auras

Corpus callosum

Dementia (anterior)

Behavioral changes (posterior)

Asymptomatic (mid)

Thalamus

Sensory loss (contralateral)

Behavioral changes

Language disorder (dominant side)

Midbrain/pineal

Paresis of vertical eye movements

Pupillary abnormalities

Precocious puberty (boys)

Sella/optic nerve/pituitary

Endocrinopathy

Bitemporal hemianopia

Monocular visual defects

Pons/medulla

Cranial nerve dysfunction

Ataxia, nystagmus

Weakness, sensory loss

Spasticity

Cerebellopontine angle

Deafness (ipsilateral)

Loss of facial sensation (ipsilateral)

Facial weakness (ipsilateral)

Ataxia

Cerebellum

Ataxis (ipsilateral)

Nystagmus

Filed under: Brain tumors by Canadian pharmacy