Clinical Presentation of Brain Metastases
Brain metastases can result in a large variety of focal and nonfocal neurological symptoms. The clinical presentation of brain metastases is affected by the location, size and growth rate of the tumour. Any new neurological symptom or change in behaviour or cognition in a patient with cancer warrants further investigations for brain metastases. Focal neurological symptoms, like hemiparesis and dysphasia, can be caused by a direct effect of the brain metastasis or the surrounding oedema on the brain tissue or other neural structures. Most of these neurological symptoms occur within days to weeks, although an intratumoural haemorrhage can result in an acute onset of symptoms. Epileptic seizures occur in 10–20% of patients with brain metastases.
KeywordsBrain metastases Neurological symptoms Hydrocephalus Brain herniation Epilepsy
- 7.Chang EL, Wefel JS, Maor MH, Hassenbusch SJ 3rd, Mahajan A, Lang FF, 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(2):277–83.; ; discussion 283–4. https://doi.org/10.1227/01.neu.0000249272.64439.b1.CrossRefPubMedGoogle Scholar
- 8.Mehta MP, Rodrigus P, Terhaard CH, Rao A, Suh J, Roa W, 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(13):2529–36. https://doi.org/10.1200/jco.2003.12.122.CrossRefPubMedGoogle Scholar
- 9.Meyers CA, Smith JA, Bezjak A, Mehta MP, Liebmann J, Illidge T, et al. Neurocognitive function and progression in patients with brain metastases treated with whole-brain radiation and motexafin gadolinium: results of a randomized phase III trial. J Clin Oncol. 2004;22(1):157–65. https://doi.org/10.1200/jco.2004.05.128.CrossRefGoogle Scholar
- 18.Oberndorfer S, Schmal T, Lahrmann H, Urbanits S, Lindner K, Grisold W. The frequency of seizures in patients with primary brain tumors or cerebral metastases. An evaluation from the Ludwig Boltzmann Institute of Neuro-Oncology and the Department of Neurology, Kaiser Franz Josef Hospital, Vienna. Wien Klin Wochenschr. 2002;114(21–22):911–6.PubMedGoogle Scholar