Chest X-ray ESR
The high incidence of metastatic tumour makes these tests mandatory in patients with suspected intracranial tumour.
Signs of raised intracranial pressure
- Suture separation (diastasis)
- in infants
- 'Beaten brass' appearance - of limited value since it may occur normally in children and in
J J some adults.
Skull X-ray Note:
- oglidendroglioma N
- meningioma (look for hyperostosis of adjacent bone)
- primary or secondary bone tumour
- nasopharyngeal carcinoma
CT scanning Note:
e.g. frontal, occipital
brain substance, e.g. meningioma
- intrinsic: within ^ brain parenchyma, e.g. astrocytoma.
MASS EFFECT / -midline shift. - ventricular compression, -hydrocephalus (secondary to 3rd ventricular or posterior fossa lesion).
-------/---)>---erosion of the posterior clinoids
I (may also occur from local pressure, e.g. craniopharyngioma.
Single or multiple lesions if multiple -> metastasis
Effect of contrast enhancement e.g. none - low grade astrocytoma irregular - malignant astrocytoma homogeneous - meningioma
HIGH DEFINITION SCANS (1.5 mm slice width) - useful in the detection of pituitary, orbital and posterior fossa tumours.
CORONAL AND SAGITTAL RECONSTRUCTION DIRECT CORONAL SCANNING
useful in demonstrating the vertical extent of a tumour and its relationship with other structures - especially when intraventricular or arising from the pituitary fossa or skull base. Now replaced by MRI.
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