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Intracranial Tumours and other SOLs

“This is a depiction of a man with a brain tumour. Headache, a typical symptom, has been shown.” © https://www.myupchar.com/en CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0/)

Space-Occupying Lesions

Tumours - 30% are metastatic, commonly from lung, breast, kidney, skin


Other SOLs – Aneurysm, Abscess, Chronic subdural haematoma, Granuloma, Cyst


Types of Intracranial Tumours

  • 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


Presentation

  • 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


Investigations

  • MRI

  • Biopsy


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



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