Intracranial space occupying lesions

Introduction In the normal human cranial cavity, there are mainly brain tissue, cerebrospinal fluid, cerebral blood vessels and blood flowing in the lumen. Under normal circumstances, the cranial cavity is completely closed, the volume of the cranial cavity and the volume of the contents contained therein are constant, and the intracranial pressure is maintained (about 0.686-1.96 kPa, or 70-180 mm water column). The so-called intracranial space-occupying lesion refers to a certain space in the cranial cavity occupied by focal lesions, causing clinical focal neurological symptoms, signs and increased intracranial pressure. This lesion is called intracranial space-occupying lesion.

Cause

Fever, tuberculosis, parasitic infections, chronic otitis media and other infections, cancer, and history of trauma.

1 various types of intracranial hematoma caused by craniocerebral injury (such as epidural, inferior hematoma, intracerebral hematoma, mixed hematoma).

2 various spontaneous intracranial hemorrhage and hematoma.

3 various primary and metastatic tumors in the brain.

4 intracranial abscess.

5 various granuloma in the skull.

6 various parasitic diseases in the skull.

7 other space-occupying lesions.

an examination

Related inspection

Brain CT examination of brain MRI examination of intracranial ultrasound examination of intracranial pressure monitoring intracranial Doppler blood flow map (TCD)

Pay attention to the presence or absence of subcutaneous nodules, swollen lymph nodes, cutaneous vasospasm, sputum, pigmentation, purple streaks, head deformities, bulges, tenderness, vascular anger, head and neck and ocular murmurs, hepatosplenomegaly, Pathological obesity, etc. Look at the organs such as heart and lungs.

Intracranial space-occupying lesions, such as small lesions, are located in non-significant functional areas and are clinically asymptomatic. If the lesion is located in an important brain function area or a large range of lesions, symptoms of increased intracranial pressure (such as headache, nausea, vomiting, etc.) and focal neurological signs often occur. Larger space-occupying lesions cause excessive intracranial pressure and oppress the brain tissue, which can cause paralysis of the limbs and even the formation of cerebral palsy. Cerebral palsy is a sign that threatens the lives of patients and is the most serious consequence of intracranial space-occupying lesions.

Intracranial space-occupying lesions can often be diagnosed by imaging examination. Imaging examinations include CT scans of the head, MRI, and cerebral angiography. Modern imaging examination can show the location, size, shape and number of space-occupying lesions, and whether cystic changes, necrosis, calcification, and hemorrhage can be observed inside the lesion. Cerebral angiography is based on the location of blood vessels, changes in morphology, changes in circulation time, and the appearance of pathological blood vessels. It indirectly understands the location, general shape, and richness of blood vessels.

Differential diagnosis

diagnosis

A mass-like lesion that occupies a certain spatial position in the cranial cavity. Such as brain tumors, brain abscesses and cerebral hematoma. As the volume of the lesion increases, the intracranial pressure is physiologically decompensated, and the intracranial pressure exceeds the normal value (80-180 mmH2O), often accompanied by brain dysfunction.

1 Headache: When the intracranial pressure is increased, the meninges and important vascular nerves are caused by pulling. It is not typical at the beginning of the onset, and it can be persistent and even unbearable when it is heavy.

2 vomiting: is the brain stem shift and traction or tumor directly stimulate the vomiting center of the medulla, vomiting is jetting, without other gastrointestinal symptoms, often occurs when the headache is severe, and the headache is slightly relieved after vomiting. Because of the tumor, the child often occurs in the posterior cranial fossa. It can cause vomiting in the early stage and is easily misdiagnosed as digestive tract disease.

3 papilledema: increased intracranial pressure, obstructed ocular venous return, blurred nipple border, venous congestion, exudation or bleeding. Early visual acuity was normal, and visual acuity gradually decreased due to secondary optic atrophy in the middle and late stages.

4 seizures: is an abnormal discharge produced by the cortical layer in the space-occupying lesions. Seizures in adults are often caused by space-occupying lesions.

5 Double vision, tinnitus, and mental disorder.

6 cerebral palsy: is a late complication of increased intracranial pressure.

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