Presentation
As many as 0.6% of patients present with PCNSL concurrent with the diagnosis of AIDS, and early estimates suggested that 2% to 6% of AIDS patients would ultimately develop the disorder. [ajnr.org]
Case Presentation A 35-year-old woman presented with headache and left-sided weakness. MRI scans initially mislead us to a diagnosis of glioblastoma (GBM). Surgery was performed. The mass was sub-totally resected. [wjso.biomedcentral.com]
Presentation Presenting features may include localising signs, generalised signs and false localising signs. A rapid onset of symptoms suggests a cerebrovascular lesion whilst a space-occupying lesion of the brain will usually be more gradual. [patient.info]
CASE 2 An AfroCaribbean woman aged 33 presented with a cluster of four right sided sensorimotor seizures with secondary generalisation. On examination she was drowsy and had a mild right hemiparesis. [jnnp.bmj.com]
Signs and Symptoms Presenting complaints of patients with an intracranial neoplasm tend to be similar for primary brain tumors and intracranial metastases. [emedicine.medscape.com]
Neurologic
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Encephalopathy
Usually, the patient with CNS toxoplasmosis will present with focal neurologic symptoms and signs often superimposed on a global encephalopathy. Mild hemiparesis is the most common focal finding. [ajnr.org]
unspecified G93.41 Metabolic encephalopathy G93.49 Other encephalopathy G93.5 Compression of brain G93.7 Reye's syndrome G93.8 Other specified disorders of brain G93.81 Temporal sclerosis G93.89 Other specified disorders of brain G93.9 Disorder of brain [icd10data.com]
[…] automatism Compression of brain due to focal lesion Cortical paralysis of fixation syndrome Discrimination disorder Dorsal midbrain syndrome Electrocerebral silence Electrocerebral silence (brain death) Hamartoma of brain Infectious disease of brain Ischemic encephalopathy [icd9data.com]
Individuals can develop encephalopathy due to a variety of chemicals and substances that build up in the blood stream. Ammonia levels rise in patients with liver failure while patients with kidney failure can become uremic. [medicinenet.com]
The tertiary stage may mimic many conditions, including multiple sclerosis, polyneuropathy, viral encephalitis, brain tumor, vasculitis, encephalopathy, psychiatric illness, and myelopathy. [canlyme.com]
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Lethargy
Headache, confusion, lethargy, brain stem and cerebellar disorders, and seizures are also observed ( 2, 3 ). [ajnr.org]
In addition to headaches, increased pressure within the head can produce nausea, vomiting, lethargy, double or blurred vision and trouble with balance or walking. A man is laying in bed with a headache. [livestrong.com]
[…] fluid (CSF) May obstruct the fourth ventricle, causing hydrocephalus (water on the brain) Occurs most often in children under the age of ten, but may occur in adults Slightly more common in males than females Symptoms Headaches Early morning vomiting Lethargy [braintumor.org]
Symptoms include: Headaches Seizures Nausea and vomiting Irritability Lethargy and drowsiness Personality and mental activity changes Macroencephaly (enlarged head) in infants whose skull bones are not completely fused Coma and death, if left untreated [hopkinsmedicine.org]
Acute effects include hair loss (alopecia), nausea, vomiting, lethargy, otitis media and severe cerebral edema. Though some of these effects can be transient, dermatitis, alopecia, and otitis media can persist for months after irradiation (23). [irsa.org]
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Speech Disorder
Language and speech disorders are very common among individuals with temporal lesions. Some visual field defects do exist. Forgetfulness, loss of concentration and awareness are also important symptoms of temporal lobe lesions. [medlicker.com]
It was negative in speech disorder and perceptual disturbance. A review of systems at the time of presentation revealed no additional symptoms, except for mild hypomnesis. There was no history of alcohol or illicit drug use. [wjso.biomedcentral.com]
disorders Vision problems Treatment Radiation therapy, chemotherapy, and steroids are the most common forms of treatment. [braintumor.org]
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Loss of Speech
These clinical features are virtually indistinguishable from those of PCNSL, which presents with confusion, lethargy, memory loss, hemiparesis, speech and language disorders, seizures, and cranial nerve palsies, in descending order of frequency. [ajnr.org]
They include: Headache Hearing loss Impaired speech (i.e., dysphasia) Incontinence Mental and emotional changes (e.g., indifference, disinhibition) Prolonged drowsiness (somnolence) Seizures Vision loss A tumor located in the pituitary gland (i.e., pituitary [healthcommunities.com]
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Chorea
One clinical feature that is believed pathognomonic of CNS toxoplasmosis is chorea; however, it is a rare occurrence. [ajnr.org]
Workup
[…] include incompatibility with certain medical equipment, longer imaging times (increased risk of motion artifact), and poor visualization of the subarachnoid space Neither CT nor MRI can be used to differentiate tumor recurrence from radionecrosis See Workup [emedicine.medscape.com]
Any adult who has a recent onset of seizures, particularly focal seizures, is considered a tumor suspect until adequate neurologic workup proves otherwise. Specific Tumor Types There are many types of tumors that develop intracranially. [dartmouth.edu]
MR
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Mass Lesion of the Brain
It does provide more data when determining whether to proceed to early biopsy for an AIDS-related mass lesion of the brain or to treat initially presumptively for toxoplasmosis. [ajnr.org]
Bibliographic Links COMMENTS The authors make a reasonably strong case that this mass lesion in the brain stem is etiologically related to neuroborreliosis. [canlyme.com]
This gives rise to a potentially lethal complication of mass lesions, herniation of brain tissue into another compartment. [dartmouth.edu]
Treatment
Regular follow-up treatment is extremely important after treatment for a brain tumor. [radiologyinfo.org]
Surgery is the standard treatment. [braintumor.org]
Treatment for Pediatric Brain Tumors One or more of these approaches will be included in the child’s brain tumor treatment plan: Surgery Most brain tumors in infants and children require surgical removal, or at least a biopsy, as part of the treatment [hopkinsmedicine.org]
Treatment is key for spinal tumours, as any damage it causes can be made more severe or indeed, permanent, if treatment is not sought soon enough. [spinalcord.com]
You will also learn about the prognostic factors doctors use to help plan treatment. Use the menu to see other pages. [cancer.net]
Prognosis
Currently, the factors listed above are the best indicators of a patient’s prognosis. [cancer.net]
Discussing treatment and prognosis with an experienced neurologist (brain doctor) is a must. In general, the ability of a brain lesion to disappear or just shrink depends on the what the lesion is. [zocdoc.com]
Brain Lesions Prognosis Because of the many different types of brain lesions, the prognosis and outcomes of brain lesions are variable. [emedicinehealth.com]
Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery) and treatment options for primary brain and spinal cord tumors depend on the following: The type and grade of the tumor. [my.clevelandclinic.org]
What is the prognosis? The prognosis of brain lesions depends on a number of variables like type of lesion, its cause, extend of the disease, type of treatment option used and success of the treatment. [medlicker.com]
Etiology
Clinical Clues to Nonmalignant Brain Lesions Clinical clues Suggested etiology Abnormalities found on more extensive imaging that are suggestive of an etiology Cysticercosis, fungal infections, sarcoidosis, tuberculosis Chronic fever; recent dental procedure [aafp.org]
The spectrum of underlying etiologies of HIV-associated intracranial mass lesions is broad. [neurology.org]
Local inflammatory responses, vasculitis, and autoimmune mechanisms have been implicated in the etiology of Lyme neuroborreliosis. [canlyme.com]
Its etiology and pathogenesis are still unknown. It is very possible that viral infections initiate the inflammatory process that somehow becomes self-sustaining [ 5 ]. [wjso.biomedcentral.com]
In some instances, however, the symptoms are specific to the etiology. Hemorrhage, which can be parenchymal or extra-axial is the most common cause of intracranial mass lesions and is discussed in Chapter 27. [dartmouth.edu]
Epidemiology
Epidemiologic studies conducted since the introduction of HAART suggest a decline in the incidence of PCNSL in the AIDS population. [ajnr.org]
Epidemiology of brain metastases. Current Oncology Reports, 14 (1), 48-54. Ramakrishna, N., Temin, S., Chandarlapaty, S., Crews, J. R., Davidson, N. E., Esteva, F. J., ... & Lin, N. U. (2014). [oncolink.org]
[…] percent of these cases were reported during the period 1981 to 1987, 41% during 1988 to 1992, and 49% during 1993 to October 31, 1995. 1 In 1990, an estimated one million individuals were infected with HIV in the United States, 2 and the more recent epidemiologic [neurology.org]
Evaluation of epidemiologic evidence for primary adult brain tumor risk factors using evidence-based medicine. Prog Neurol Surg. 2006;19:54–79. 6. Ostrom QT, et al. [aafp.org]
Pathophysiology
Reference article This is a summary article ; we do not have a more in-depth reference article. pathophysiology brain mass lesions are a very broad group of conditions infection (abscess) neoplastic brain metastases primary brain tumor (benign/slow growing [radiopaedia.org]
The exact pathophysiology of Lyme neuroborreliosis is unknown and may be multifactorial. In some specimens, the spirochete can be identified (6). [canlyme.com]
Prevention
How to Prevent Brain Lesions In some instances, certain brain lesions can be prevented, though not all types can be completely prevented. [emedicinehealth.com]
Collaborative Meta-Analysis of Randomised Trials of Antiplatelet Therapy for Prevention of Death, Myocardial Infarction, and Stroke in High Risk Patients. [books.google.es]
Measures such as neck compression (tourniquet) and volume loading can be helpful in preventing VAE. PEEP increases the risk of VAE. [openanesthesia.org]
For this reason, researchers looked at utilizing whole brain radiation as a way to prevent future brain metastases from developing. [oncolink.org]
If a person suffers from a brain lesion, immediate help is necessary to prevent further damage to the brain function. Unlock Content Over 75,000 lessons in all major subjects Get access risk-free for 30 days, just create an account. [study.com]