Central nervous system tumor: Difference between revisions

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==Evaluation==
==Evaluation==
*[[CT head]]
*[[CT head]]
*MRI required for small tumors or areas not well visualized on CT (e.g. posterior fossa)
*[[brain MRI|MRI]] required for small tumors or areas not well visualized on CT (e.g. posterior fossa)
*Evaluate for other causes of symptoms (i.e. [[stroke]], metabolic derangement, [[ICH]])
*Evaluate for other causes of symptoms (i.e. [[stroke]], metabolic derangement, [[ICH]])



Revision as of 22:29, 2 October 2019

Background

  • Metastatic tumors more common than primary CNS in adults
  • CNS tumors are second most common pediatric cancer, leading cause of cancer-related death in children
  • Most primary tumors in children are infratentorial, whereas most infratentorial masses in adults are metastases

Clinical Features

Differential Diagnosis

Evaluation

  • CT head
  • MRI required for small tumors or areas not well visualized on CT (e.g. posterior fossa)
  • Evaluate for other causes of symptoms (i.e. stroke, metabolic derangement, ICH)

Management

  • See elevated ICP
    • Corticosteroids (reduce tumor capillary permeability, inflammatory cytotoxicity)
    • Elevate head of bed to 30 degrees, provide adequate sedation in intubated patients
    • Maintain cerebral perfusion (euvolemia, vasopressors if necessary)
    • Consider osmotherapy (e.g. hypertonic saline, mannitol)
  • Treat seizure with benzodiazepines +/- AEDs, prophylactic AEDs are not recommended
  • Consult neurosurgery

Disposition

See Also

External Links

References