Space Occupying Lesions Flashcards
what are the symptoms of SOL?
raised ICP - headache worse on lying down, coughing, vomiting
papilloedema - pressure on optic nerve
reduced GCS
neck stiffness - pressure on dura around cerebellum/brainstem
what are the possible malignant tumour SOL?
astrocytoma
oligodendroglioma
medilloblastoma - children
how is medilloblastoma treated?
very radiosensitive
what are the possible benign tumour SOL?
meningioma
how is SOL diagnosed?
CT/MRI
avoid LP before imaging
what is at risk when performing LP before imaging?
coning - cerebellar tonsiles herniate through foramen magnum
what are the 4 possible complications of SOL?
subfalcine
tentorial
tonsillar herniation
transcalvarium
what is a subfalcine herniation?
asymmetric expansion of cerebral hemisphere displaces cingulate gyrus under falx cerebelli
what is subfalcine herniation associated with?
compression of ACA
what are the symptoms of a subfalcine herniation?
weakness ± sensory loss in leg
due to ischaemia to primary motor ± sensory cortex
what is a tectorial herniation?
medial aspect of temporal lobe herniates through tentorium cerebella
how does a tectorial herniation present as?
CN III palsy
therefore - pupillary dilation and impaired ocular moments
what is a tonsillar herniation?
displacement of cerebellar tonsils through the foramen magnum
how does a tonsillar herniation present as?
brain stem compression
compromises respiratory centres in medulla oblongata
what is a transcalvarium herniation?
swollen brain will herniate through any defect in dura/skull
