Space occupying lesions

Dr.saad F. Al-masoudi
 SOL
■ 1-Brain tumors
■ 2-Brain abscess
■ 3-Intracranial hemorrhage
■ 4-Parasitic infestation
■ 5-Intracranial cysts
 BRAIN TUMOR
There are 9 types of brain tumor acc. To WHO
classification and as the following:
1-tum. Of neuroepithelial tissue;
a-Astrocytoma(glioma)….
…..infilterating Ast.
…..pilocytic Ast.
…..pleomorphic xanthoastrocytoma
 B.T.
B-oligodendrocytoma
C-Ependymoma
D-mixed tum.(glioma)
E-Choroid plexus tum.
F-Pineal gland tum.
G-Emberyonal
tum.(neuroblastoma,retinoblastoma,medullobla
stoma).
 B.T.
2-TUMORS OF MENINGES
………Meningioma
3-TUMOR OF CRANIAL NERVES
……Schwannoma
……Neurofibroma
……MNST
 B.T.
4-Lymphoma &hematopoietic tum.
Malignant lymphoma,M.M.,granulocytic
sarcoma.
5-Germ cell tum.
6-cysts &tum. Like conditions
7-tumors of sellar area
8-Local extention from regional
tum…paraganglioma
 •B.T
9-Metastatic tum.breast lung,prostate,GIT,&GUT

Brain tum. Can be classified into:

1-supratentorial tum.
2-infratentorial tum.
 Clinical feature of B.T.
1-sign & sym.of raised ICP
2-Seizure
3-neurological deficit
4-dist. In level of con.
5-brain herniaton
 Image of patient with B.T.

1-Skull x-ray
2-Brain CT-Scan
3-Brain MRI,MRA,MRV
4-PET,SPECT
5-Cerebral angiography
 Treatment of B.T.
1-Medical treatment
2-Surgical treatment
3-Radiotherapy(DXT)
4-Chemotherapy
5-Radiosurgery(Gamma knife)
6-Brachytherapy,immunotherapy,phototh.
 BRAIN ABSCESS
Higher incidence in underdeveloped countries
where living conditions remain poor.
Causes:
1-suppurutive processes of paranasal
sinuses,middle ear,&mastoid
2-metastatic abscess from skin,heart&lung
3-trauma(surgical & non-surgical)
4-immune compramised patients
 Clinical feature of B.A.
1-Headache is prominent in 70-97%
2-Nausea &vomiting
3-Low grade fever
4-Focal neuro. Deficit
5-Alteration in L.O.C.
6-Seizure
 B.A.
Ix.
1-lab finding:WBC in blood,ESR,CSF ex.
2-radio.:CT-Scan,MRI,I labelled leukocyte
Rx.
1-AB.
2-Steroid
3-Surgical drainage
4-Surgical excision
 Brain parasitic infestation
Brain hydatid cyst:
Echinococcus granulosus,infest man and
developed in dogs as difinitive host.
Afflict any tissue except hair,teeth&nail.
Brain involvment in 2%(rare).
C.F./Fit & feature of raised ICP
Imaging/skull x-ray,CT,MRI
 Treatment of B.H.
A-Medical :albendazole 10mg/kg/d for 3 m.
B-surgical removal by craniatomy
Care should made to avoid its repture other wise
leading to:
1- anaphylactic shock
2- local recurrance
3-meningitis
 Intracranial Hemorrhage
Intracranial h. either traumatic or spontaneous.
Can be classified to:
1-extradural h.
2-subdural h.
3-subarachnoid h.
4-intraparanchymal h.
5-intraventricular h.
 Clinical Feature of I.H.
1-Sign & Symp. Of raised ICP
2-Seizure
3-Focal neuro. Deficit.
4-Disturbance in L.O.C.
5-Brain herniation
Imaging technique of best is CT-Scan
Rx:surgical evacuation of h. if indicated
 Intracranial cyst
A-Arachnoid cyst….congenital
B-Enlarged cisterna magna
C-Chronic subdural hematoma or hygroma
D-Posterior fossa cyst…Dandy Walker syndrome
E-Old infarction(porencephalic cyst)
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