Intracranial Tumours Clinical Features

Symptoms tend to develop insidiously, gradually progressing over a few weeks or years, depending on the degree of malignancy (cf. acute onset of a cerebrovascular accident followed by a gradual improvement if the patient survives). Occasionally tumours present acutely due to haemorrhage or the development of hydrocephalus.

Supratentorial tumours

Infratentorial tumours

MASS EFFECTS

FOCAL DAMAGE

Supratentorial tumours

Infratentorial tumours

CSF outflow obstruction

Cranial nerve damage l-VI

Cranial nerve damage lll-XII

CSF outflow obstruction

Cranial nerve damage l-VI

Cerebral Cerebellar

Cranial nerve damage lll-XII

CLINICAL EFFECTS

RAISED INTRACRANIAL PRESSURE - headache, papilledema

BRAIN SHIFT- vomiting, deterioration of conscious level, pupillary dilatation

(see pages 77-79)

EPILEPSY (see page 88)

- generalised

- partial (occur in (simple or 30% of complex) f patients

- partial with brain progressing to tumours) generalised

Partial seizures help localise the tumour site.

Pure visual (or auditory) seizures are rare.

Partial sensory seizures arise in the sensory cortex and cause numbness and tingling in the contralateral face, limbs.

Partial motor seizures arise in the motor cortex - tonic or clonic movements in the contralateral face or limbs.

Complex partial (temporal lobe) seizures arise from the medial temporal lobe - formed visual or auditory hallucinations, awareness of abnormal taste, feelings of fear, déjà vu, unfamiliarity or depcrsonalisation and automatisms.

Pure visual (or auditory) seizures are rare.

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