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118 Cards in this Set
- Front
- Back
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Cerebrovascular Accident (Stroke) |
Brain is damaged by a sudden disruption in the flow of blood to a part of the brain (embolic) or by bleeding inside the head (hemorrhagic). Aka brain attack. |
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Cerebrovascular Accident (Stroke) Signs and Symptoms |
Number one cause of adult disability. Symptoms and Signs reflect portion of the brain affected. All sudden. Severe headache, aphasia, dysphagia, or difficulty understanding language, weakness, numbness, face paralysis (hemiparalysis), impaired consciousness, impaired vision, dizziness, loss of balance. |
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Cerebrovascular Accident (Stroke) Etiology |
Clot, Embolism, Bleed. |
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Cerebrovascular Accident (Stroke) Diagnosis |
Immediate (w/in 3 hrs). Anticoagulant (heparin), thrombolytic agents, anti platelet meds (aspirin). |
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Cerebrovascular Accident (Stroke) Prognosis |
Varies. Brain cells destroyed do not recover and are not replaced. |
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Transient Ischemic Attack (Little Stroke) |
Temporary episodes w duration of less than 24 hrs of impaired neurologic function |
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Transient Ischemic Attack (Little Stroke) Signs and Symptoms |
Can occur at various sites so various diagnostic codes. Sudden weakness, numbness down one side of body, dizziness, dysphagia, confusion, difficulty seeing from one eye, loss of balance. Usually do not cause unconsciousness. Normally do not cause permanent damage. |
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Transient Ischemic Attack (Little Stroke) Etiology |
Piece of plaque formed by atherosclerosis (embolus). |
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Transient Ischemic Attack (Little Stroke) Diagnosis |
Determine source of embolus. Carotid likely source. Cranial MRI, CT, EEG, |
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Transient Ischemic Attack (Little Stroke) Treatment |
Depends on location. Anticoagulant, chew aspirin, surgery to increase blood flow. |
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Transient Ischemic Attack (Little Stroke) Prognosis |
Varies on extent and duration of ischemia. Most have minimal residual effects. Warning for future CVA. Stress reduction and lifestyle changes to reduce risk. |
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Epidural Subdural Hematomas |
Collection or mass of blood that forms bt the skull and dura mater. Blood collects or pools bt the dura mater and the arachnoid membrane (2nd meningeal membrane) |
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Epidural Subdural Hematomas Signs and Symptoms |
Pressure on the brain results in impaired functioning of the brain or possible death. Symptoms appear w/in few hrs of trauma. Sudden headache, dilated pupils, nausea, vomiting, drowsiness, hemiparesis. If not treated can lead to coma, or death. Subdural similar to epidural hematoma but delayed and slower. Mimic TIA, stroke, dementia. Have diplopia. |
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Epidural Subdural Hematomas Etiology |
Both result from ruptured vessels seeps into and around the meningeal layers. Head trauma usual cause. |
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Epidural Subdural Hematomas Diagnosis |
Cranial radiographic films, CT, cerebral arteriograms to locate hematoma. |
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Epidural Subdural Hematomas Treatment |
If lose consciousness rapid medical attention. Craniotomy or cranial trephination (bur hole) to relieve pressure. |
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Epidural Subdural Hematomas Prognosis |
Prompt assessment and intervention lead to good prognosis. |
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Cerebral Concussion |
Bruising of cerebral tissue by back and forth movement of head or blunt force trauma. |
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Cerebral Concussion Signs and Symptoms |
Loss of consciousness “knocked out”. Shallow respiration, pulse rate depressed, muscle tone flaccid. After regain consciousness: headache, nausea, vomiting, diplopia, blurred vision, photophobia. Irritability, decreased level of concentration, amnesia. |
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Cerebral Concussion Etiology |
Impact or blow to the head. Disruption of normal electrical activity in the brain. Mild traumatic brain injury. |
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Cerebral Concussion Diagnosis |
CT. |
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Cerebral Concussion Treatment |
Quiet bed rest, w observation for signs of behavioral changes. Can be allowed to sleep but make sure they can be fully awake when aroused. If any changes could mean progressive brain injury. |
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Cerebral Concussion Prognosis |
Unpredictable depends on extent of injury and additional trauma. Many people recover. |
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Cerebral Contusion |
More serious than concussion. Bruising of tissue along or just beneath the surface of the brain. Contrecoup insult. |
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Cerebral Contusion Signs and Symptoms |
Persist longer than 24 hrs. Range from temporary loss of consciousness to coma. If conscious have headaches, and hemiparesis. Drowsy, lethargic, or hostile and combative. |
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Cerebral Contusion Etiology |
Blow to head car accident. Often associated w skull fracture. |
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Cerebral Contusion Treatment |
Hospitalized so vitals monitored and medical intervention is rapid if needed. Prognosis unpredictable. |
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Depressed Skull Fracture |
Skull bones pushed below normal surface of skull. |
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Depressed Skull Fracture Signs and Symptoms |
Depend on site of fracture. If motor area can cause hemiplegia. Typically not progressive. Remain static till bone is elevated. Seizures common. Bleeding from would, ears, nose, around eyes. Pupils change (unreactive or unequal) bruise behind ear (battle sign) or raccoon eyes. Clear or bloody drainage from nose. |
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Depressed Skull Fracture Etiology |
Blunt force trauma, auto accident, domestic abuse. |
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Depressed Skull Fracture Treatment |
Relieve intracranial pressure. Craniotomy, head protection worn till fracture at least partially healed. Prognosis unpredictable. |
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Paraplegia and Quadriplegia |
Para- loss of nerve function below the waist and paralysis of the lower trim I and waist. Quadra- loss of nerve function at the cervical region resulting in paralysis of the arms hands trunk and legs |
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Paraplegia and Quadriplegia Signs and Symptoms |
Sometimes temporary but usually leads to some degree of permanent disability. Para: loss if motor and sensory of trunk and lower extremities. Loss of bowel, bladder, and sexual function common. Quadra: hypotension, hypothermia, bradycardia, respiratory problems can use mechanical ventilation. |
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Paraplegia and Quadriplegia Etiology |
Spinal cord injuries, vertebral fractures or dislocations. T1 and below results in paraplegia, Vertebral compression and hyperflexion of the spine. C5 and above results in quadra. C5-7 produce varying degrees of paresis to shoulders and arms. Damage above C 3 usually fatal, typically caused by hyperextension or flexion to that portion. |
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Paraplegia and Quadriplegia Treatment |
Restoration and normal alignment and stability of the spine. Decompression of spinal cord, nerves, and vertebrae. Immediately stabilize neck and spine to prevent further damage. Corticosteroids to slow edema. Hypothermic state to area for edema. |
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Paraplegia and Quadriplegia Prognosis |
Guarded. Earlier treatment better prognosis. Partial or total severing of spinal cord has permanent irreversible damage and paralysis below insult. |
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Degenerative Disk Disease |
Natural part of aging occurs in everyone over time. |
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Degenerative Disk Disease Signs and Symptoms |
Pain, radiates down nerve path (dermatome) may be described as burning. Constant back pain, and pain that radiates down one or both legs, loss of some motor functions in the legs. Numbness and tingling w weakness. |
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Degenerative Disk Disease Etiology |
As age water in disk decreases causing degeneration. May be mechanical or constant wearing. Misalignment cause constant rubbing results in inflammation and gradual destruction. Inflammation eventually involves spinal nerve roots which cause scarring. |
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Degenerative Disk Disease Treatment |
Be as active as possible. Narcotic analgesic and NSAIDs for pain. Oral steroids, epidurals. Back brace, surgical intervention (spinal fusion or freeing spinal nerve root from entrapment). Pain pump last resort. Prognosis varies. |
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Herniated and Bulging Disk |
(Ruptured or slipped disk), nucleus pulposus (gelatinous center of disk) through the annular wall of disk and into spinal canal. |
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Herniated and Bulging Disk Signs and Symptoms |
Severe back pain. Sudden sharp pain, worsens w movement, radiates from back to butt, thighs, leg following impinged nerve. Parathesia, muscle weakness. Most in lower back T4/5 and first sacral. If in cervical pain in arms and neck. Can be uni or bilateral. |
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Herniated and Bulging Disk Etiology |
Accumulated trauma ( improper body mechanic when lifting) or sudden impact. Poor posture and aging. Can occur at time of trauma or shortly after. |
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Herniated and Bulging Disk Treatment |
Hot or cold packs, muscle relaxants, analgesic, epidural injections, pt. Surgical excision of disk ( diskectomy, or microdiskectomy). Bulging disk often resolve w rest and drug therapy. Many herniated disks resolve w conservative care. Prognosis varies, surgery outcomes favorable. |
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Sciatic Nerve Injury- Spinal Stenosis |
Pathological condition. Trauma, degeneration, or rupture of nucleus pulposus w/in intervertebral disk. Spinal stenosis is narrowing of spinal canal (sciatica) bc of the compression on the spinal cord and spinal nerve roots. |
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Sciatic Nerve Injury- Spinal Stenosis Signs and Symptoms |
Sharp pain from sciatic nerve down the leg to the foot. May be continuous or intermittent skin supplied by affected nerve may feel numb. Sciatica has low back pain and leg pain. Anterior or lateral ruptures may not produce symptoms. Nerve injury can lead to disability. Stenosis have back pain radiating down leg, butt, thighs or calves increase w standing walking or exercise. Numbness in same areas. Weakness in legs. |
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Sciatic Nerve Injury- Spinal Stenosis Etiology |
Trauma to sciatic nerve can be fall, poor posture, poor body mechanics, gunshot or stab wound. Aging can lead to degeneration and narrowing of spinal canal, inflammatory autoimmune response can speed up degeneration. |
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Sciatic Nerve Injury- Spinal Stenosis Treatment |
Corticosteroids, pt, exercise to strengthen back and ab muscles. Analgesic, anti inflammatory, anti seizures to slow nerve impulse. Hot and cold packs, massages. Surgical intervention (partial or complete removal of disk, fusion, decompression of spine). Prognosis varies. |
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Migraine Signs and Symptoms |
Before onset may have visual auras (flashing lights) photophobia, numbness, tingling in one arm or one side, dizziness, temp mental confusion. Become less frequent and intense w age. Women 2x as men. |
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Migraine Etiology |
Unknown. Could be genetic, certain food, changes in cerebral blood flow. |
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Migraine Treatment |
Bed rest, quiet, dark room, analgesics. Antiemetics for vomiting. Prognosis favorable w rest and drug therapy. |
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Epilepsy: Seizure Disorder |
Chronic brain disorder. Sudden episodes of abnormal intense electrical activity in the brain which results in a seizure. |
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Epilepsy First Aid |
Cushion head, loosen tight neckwear, turn on side, nothing in mouth, look for ID, don’t hold down, offer help once it ends. |
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Epilepsy: Seizure Disorder |
Many forms, variety of manifestations, can have more than one type. |
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Epilepsy: Seizure Disorder Recurring Seizures |
Involuntary contractions of muscles (convulsions) w disturbances of consciousness and sensory phenomena. Epileptic Seizures are partial or generalized. |
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Epilepsy: Seizure Disorder Partial Seizures |
Do not involve the entire brain but arise from a localized area of the brain. May involve the hands or face w motor signs, such as rhythmic twitching of a group of muscles or lip smacking or picking at clothing. Behavioral, psychic, and sensory manifestations can occur. Patient experiences amnesia of attack but no loss of consciousness occurs. |
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Epilepsy: Seizure Disorder Generalized Seizures |
Diffuse electrical abnormality w/in the brain and include absent (petit mal) and tonic-clonic (grand mal) attacks. |
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Epilepsy: Seizure Disorder Absence (petit-mal) Seizures |
Brief change in the level of consciousness, staring, blinking, or blankly staring w loss of awareness of surroundings. Last a few seconds can occur multiple times per day if not treated. Mostly in children and young adults. |
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Epilepsy: Seizure Disorder Tonic-Clonic (grand mal) Seizure |
May begin w loud cry followed by falling to ground and loss of consciousness. Body stiffens and tongue may be bitten. Prolonged contraction of the respiratory muscles may cause to become cyanotic. Rhythmic muscle contractions followed by relaxation. May urinate or defecate. Subside in 1-2 min. Consciousness regained slowly, feel drowsy, confused, weak, headache, no memory of event. Time is referred to as “postictal period”. |
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Epilepsy: Seizure Disorder Status Epilepticus |
When one seizure follows another w no recovery of consciousness bt attacks. Medical emergency requires immediate anticonvulsant therapy to prevent cerebral anoxia, hyperpyrexia, vascular collapse, or death. |
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Epilepsy: Seizure Disorder Etiology |
Symptomatic epilepsy: known abnormality of the brain from pathologic process, genetic or acquired tigger seizures. (Scar tissue, trauma, TIA, CVA, neoplasm, edema, birth trauma, drug toxicity. |
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Epilepsy: Seizure Disorder Treatment |
Anticonvulsant meds. Prognosis varies, drugs usually control. |
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Parkinson Disease |
Common slow progressive neurological disorder. Pill rolling tremor, slow movements, postural instability. |
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Parkinson Disease Signs and Symptoms |
Gradual and subtle onset. Vary from person to person associated w aging. Primary symptom is tremor or trembling hands, arms, jaw, face, and legs. Rigidity and stiffness of limbs and trunk cause stooped posture. Slow shuffling gait. Head bowed, body flexed forward, knees slightly bent. Fall often. Expressionless face, speech muffled, swallowing difficult. More men than women usual lifespan after diagnosis is 10yrs |
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Parkinson Disease Etiology |
Deficiency of dopamine (used as diagnosis). Parkinsonism can occur after ingestion of poison, encephalitis, taking certain major tranquilizers, and certain antihypertensive drugs. |
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Parkinson Disease Treatment |
Individualized bc varies of symptoms. No cure. Deep brain stimulation (DBS) decrease involuntary movements. |
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Huntington Chorea |
Hereditary degenerative disease of cerebral cortex and basal ganglia. Progressive atrophy of brain. |
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Huntington Chorea Signs and Symptoms |
Chronic progressive chorea (ceaseless, uncontrolled, involuntary, movements). Insidious onset. Typically arms and face are first involved (mild fidgets, tongue smacking) difficulty swallowing, speech difficulties, emotional state deteriorates, dementia. Moody behavior, memory loss, paranoia begin middle age. |
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Huntington Chorea Etiology |
Autosomal dominant trait can be inherited by either sex. |
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Huntington Chorea Treatment |
No cure. May be institutionalized to manage deteriorating condition. |
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Amyotrophic Lateral Sclerosis (ALS) |
Lou Gehrig Disease. Progressive destructive motor neuron disease results in muscular atrophy. |
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Amyotrophic Lateral Sclerosis (ALS) Signs and Symptoms |
Fasiculations (small local involuntary muscular contractions) accompanying atrophy and weakness noted in forearm and hands. Difficulties w speech chewing swallowing and breathing. Eventually ventilator required. No sensory neuron involvement, functioning of mind not affected. Men more than women. |
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Amyotrophic Lateral Sclerosis (ALS) Etiology |
Uncertain may be autosomal inherited traits. |
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Amyotrophic Lateral Sclerosis (ALS) Treatment |
Riluzole shown to extend lifespan, muscle relaxers. No cure usually die w/in 6-10 years. |
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Transient Global Amnesia |
Temporary ( usually 1-6) up to 12 hours. Encompasses entire memory of current events. Total loss of recent memory. Learning process completely blocked. |
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Transient Global Amnesia Signs and Symptoms |
Confusion apparent. Memory loss may encompass preceding 3-5 years and specific events. Memory returns 6-12 hours. Period of amnesic experience will remain unavailable to recall. May also include a few hours to days before event. |
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Transient Global Amnesia Etiology |
Unknown. Stress emotional events, swimming in cold water, driving, sex. Good prognosis reoccurrence unlikely will never regain memory of event. |
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Peripheral Neuritis/Neuropathy |
Degeneration of the peripheral nerves |
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Peripheral Neuritis/Neuropathy Signs and Symptoms |
Degeneration of peripheral nerves affects the distal muscles of the extremities. Loss of sensation in hands and feet followed by flaccid paralysis and wasting of muscles in those areas. Deep tendon reflexes diminished, tenderness in atrophied muscles. Skin glossy red, sweating decreased. Foot drop experienced, pain in affected areas. |
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Peripheral Neuritis/Neuropathy Etiology |
Chronic alcohol intoxication, toxicity from arsenic, lead, Carbon disulfide, phosphorus, benzene. Mumps, Pneumonia, diphtheria. Diabetes, rheumatoid arthritis, lupus, gout. |
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Peripheral Neuritis/Neuropathy Treatment |
Ascertain cause, correct or eliminate condition. Remove toxic substance, stop drinking, correct vitamin and nutritional defects. |
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Trigeminal Neuralgia (Tic Douloureux) |
Pain of the area innervated by the 5th cranial nerve (trigeminal nerve). |
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Trigeminal Neuralgia (Tic Douloureux) Signs and Symptoms |
Excruciating pain on any of the 3/5 cranial nerve branches (ophthalmic, maxillary, mandibular). Ophthalmic:pain in eye and forehead. Maxillary: nose upper lip and cheek. Mandibular: lower lip, outer portion of tongue, area of cheek close to ear. More than one branch can be involved, does not cross midline only occur on one side of face. Abrupt and sudden, sleep poorly, undernourished, dehydrated bc chewing/swallowing cause pain. |
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Trigeminal Neuralgia (Tic Douloureux) Etiology |
Uncertain. Compression of nerve root by tumor or vascular lesion. Sequela to multiple sclerosis or herpes zoster. |
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Trigeminal Neuralgia (Tic Douloureux) Treatment |
Analgesic for pain. Carbamezepine affective. Anticonvulsant but can have side effects (double vision, drowsiness, nausea) muscle relaxant (can cause depression, confusion, drowsiness). Surgical intervention to dissect root last resort. Stop smoking. |
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Trigeminal Neuralgia (Tic Douloureux) Prognosis |
Varies. Some resolve spontaneously, others to drug therapy. Surgery last resort but nerve function may be compromised. |
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Bell Palsy |
Disorder of facial nerve (7th cranial nerve) sudden onset of weakness or paralysis of facial muscles. |
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Bell Palsy Signs and Symptoms |
May have drain or drawing sensation behind the ear then inability to open or close eye and drooping of the mouth and drooling. Often develops overnight. Facial expression distorted, taste perception diminished, loss of appetite. Unilateral. May be transient or permanent occurs bt 20-60 yrs. |
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Bell Palsy Etiology |
Blockage of impulses from facial nerve caused by compression of the nerve in the bony canal. Bilateral has been noted in people w Lyme disease. |
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Bell Palsy Treatment |
Early treatment critical. Warm moist heat, gentle massage, facial exercises to stimulate muscle tone. Prednisone for inflammation, analgesics, eye patch. Prognosis: complete recovery possible often spontaneously. Can have residual damage for a period of time. |
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Meningitis |
Inflammation of meninges. |
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Meningitis Signs and Symptoms |
Vomiting, headache increases in intensity w movement or shaking of head. Nuchal rigidity, stiffness of the neck that resists any sideways or flexion-extension of head. Positive Kernig sign ( resistance to leg extension after flexing thigh on body) and Brudzinski sign ( neck flexion cause flexion of hips) photophobia, irritability, hypersensitivity of skin. Seizures, drowsiness, stupor, coma. |
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Meningitis Etiology |
Bacterial or viral. Can originate directly from brain, spinal cord or sinuses, also open head injuries. Haemophilus influenzae, Neisseria meningitidis, Strep are often bacteria responsible. Can be from causative microorganisms. |
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Meningitis Treatment |
Treated aggressively w iv antibiotics. Anticonvulsant to control seizures, glucocorticoids for cerebral inflammation and edema. NSAIDs for headache. Kept in quiet dark room. |
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Meningitis Prognosis |
Unpredictable. Bacterial forms respond well to aggressive antibiotics. Most viral forms run their course. Residual damage depends on drug therapy. |
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Encephalitis |
Inflammation of brain tissue |
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Encephalitis Signs and Symptoms |
Insidious or sudden onset. Headache, elevated temp, stiffness of neck and back, muscular weakness, restlessness, visual disturbances, lethargy. Mental confusion progresses to disorientation and even coma |
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Encephalitis Etiology |
Viruses or toxins from chickenpox, measles or mumps. Most from mosquito bites. |
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Encephalitis Treatment |
Antiviral agents only for herpes simplex encephalitis. Otherwise treatment is symptomatic w analgesic for pain and antipyretic for temp, anticonvulsant for seizures, antibiotics for infection. |
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Encephalitis Prognosis |
Unpredictable. Most viral run their course. Residual damage to brain tissue may result. |
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Guillian-Barré Syndrome |
Acute rapidly progressive disease of PNS. |
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Guillian-Barré Syndrome Signs and Symptoms |
Numbness and tingling of feet and hands. Followed by increasing muscle pain and tenderness. Progressive muscle weakness and paralysis usually in lower extremities the upper in 24-72 hrs. Most have ascending paralysis occasionally some have descending weakness and paralysis. Difficult to swallow and respiratory insufficiency. |
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Guillian-Barré Syndrome Etiology |
Autoimmune basis. Known to follow a respiratory infection or gastroenteritis in 10-21 days. Demyelination of nerves occurs. |
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Guillian-Barré Syndrome Treatment |
Elevated proteins in CSF is Diagnosis. Hospitalization required. Plasmapheresis washes plasma to remove antibodies shortening time for recovery. Iv human immunoglobulin beneficial. Recovery usually complete. |
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Brain Abscess |
Collection of pus anywhere in brain tissue. |
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Brain Abscess Signs and Symptoms |
Headache. Intracranial pressure, nausea, vomiting, visual disturbances, unequal pupil size, seizures. Nuchal rigidity. |
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Brain Abscess Etiology |
Local infection or secondary to infection elsewhere in body. Common from staph, strep, pneumococci. Can be secondary to sinusitis, otitis, dental abscess, Subdural empyema, bacterial endocarditis. |
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Brain Abscess Treatment |
Iv antibiotics, mannitol or steroids to reduce cerebral edema, surgical drainage of abscess to relieve pressure and culture organism. Prognosis varies. |
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Poliomyelitis and Post-Polio Syndrome |
Viral infection of the anterior horn cells of the gray matter of the spinal cord cause selective destruction of the motor neurons. |
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Poliomyelitis and Post-Polio Syndrome Signs and Symptoms |
Highly contagious no longer a threat due to Salk and Sabin vaccines. Low grade fever, profuse discharge from nose, malaise. Progressive muscle weakness, stiff neck, nausea vomiting, flaccid paralysis of muscles involved. Then atrophy of muscles, decreased tendon reflex, then muscle and joint deterioration. Involves muscles supplied by spinal nerves |
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Poliomyelitis and Post-Polio Syndrome Etiology |
Poliovirus enters through nose and throat crosses into gi tractand reproduces in lymphoid tissue. Travels by bloodstream into CNS where adults motor neurons. Incubation period 7-21 days. Transmitted person to person by infected oropharyngeal secretions or feces. |
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Poliomyelitis and Post-Polio Syndrome Treatment |
Analgesic for pain, moist heat, bed rest, physical therapy, use of braces may be necessary. May need ventilation if difficulty breathing. 3 serotypes of polio all 3 have immunization w Sabin trivalent oral vaccine. |
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Post polio |
Occurs later in life w people who have experienced polio. Functional deterioration of muscles is accompanied by loss of strength. Progressive weakness 30 or more years after attack and involves already affected muscles. Fasciculations and muscular atrophy accompany weakness. |
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Poliomyelitis and Post-Polio Syndrome Prognosis |
Fair, depends on muscles involved. If muscles involved w respiration may need to maintain ventilation. Muscles in arms and legs require intensive rehab w pt. Post polio has good prognosis. |
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Intracranial Tumors (Brain Tumors) Signs and Symptoms |
Displacement and compression of normal brain tissue causing neurological deficits cerebral edema, intracranial pressure possible herniation. Headache (dull, constant worse at night). Focal or generalized seizures (common if secondary) nausea vomiting, syncope, memory problems personality changes, muscle weakness, sensory loss, aphasia, visual dysfunction. Cerebral tumors often have gait disturbances, nystagmus, lethargy, dysarthric speech patterns, balance difficulties. |
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Intracranial Brain Tumors Etiology |
Therapeutic ionizing radiation, genetic predispositions (neurofibromas von Hippel-Lindau Syndrome) greater in industrialized countries. |
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Intracranial Brain Tumor Treatment |
Surgery and radiotherapy and chemo. For secondary tumors whole brain radiation therapy (WBRT) |
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Intracranial Brain Tumor Prognosis |
5 yr survival is about 30% for adults 70% for kids. |
