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brain_metastases_clinical_features

Brain metastases Clinical Features

In 30% of patients with brain metastases (BM), neurological symptoms are the first clinical manifestation of systemic malignancy, referred to as BM from cancer of unknown primary site (BM-CUPS).

Presenting symptoms include headache (49%), focal weakness (30%), mental disturbances (32%), gait ataxia (21%), seizures (18%), speech difficulty (12%), visual disturbance (6%), sensory disturbance (6%), and limb ataxia (6%) 1).

Neuropsychological testing demonstrates cognitive impairment in 65% of patients with brain metastases 2) 3) , which might be a result of destruction or displacement of brain tissue by the expanding tumor, peritumoral edema leading to further disruption of surrounding white matter tracts, increased intracranial pressure, and/or vascular compromise.

1)
Posner JB. Neurologic Complications of Cancer. Vol. 37. Philadelphia: Davis FA; 1995. Paraneoplastic Syndromes; p. 311.
2)
Chang EL, et al. A pilot study of neurocognitive function in patients with one to three new brain metastases initially treated with stereotactic radiosurgery alone. Neurosurgery. 2007;60:277–283.
3)
Mehta MP, et al. Survival and neurologic outcomes in a randomized trial of motexafin gadolinium and whole-brain radiation therapy in brain metastases. J Clin Oncol. 2003;21:2529–2536
brain_metastases_clinical_features.txt · Last modified: 2019/09/10 19:32 by administrador