Essentials of Human Diseases and Conditions 4th edition

1
Essentials of Human Diseases and Conditions 4th
edition

• Margaret Schell Frazier
• Jeanette Wist Drzymkowski

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Chapter 13Neurologic Diseases and Conditions
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Learning Objectives

• Name the main components of the nervous system.
• List some of the problems to which the nervous
  system is susceptible.
• Describe how data are collected during a
  neurologic assessment.
• Name the common symptoms and signs of a
  cerebrovascular accident (CVA).

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Learning Objectives (contd.)

• Name the three vascular disorders that may cause
  a CVA.
• Define a transient ischemic attack (TIA).
• Distinguish between (a) epidural and subdural
  hematomas and (b) cerebral concussion and
  cerebral contusion.
• Name three mechanisms of spinal injuries.
• Name the goals of treatment of spinal cord
  injuries.

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Learning Objectives (contd.)

• Explain the neurologic consequences of the
  deterioration or rupture of an intervertebral
  disk.
• Describe the symptoms of migraine.
• Explain why cephalalgia sometimes is considered a
  symptom of underlying disease.
• Describe first aid for seizures.

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Learning Objectives (contd.)

• Explain how the symptoms of Parkinson disease are
  controlled.
• Describe the progression of amyotrophic lateral
  sclerosis (ALS).
• Discuss transient global amnesia.
• Distinguish between trigeminal neuralgia and Bell
  palsy.

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Learning Objectives (contd.)

• List the diagnostic tests used for meningitis and
  explain how the causative organism is identified.
• Name the common causes of encephalitis.
• Explain the pathologic course of Guillain-Barré
  syndrome.
• Explain what is meant by postpolio syndrome.

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Chapter 13Lesson 13.1
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Orderly Function of the Nervous System

• The nervous system is a complex network comprised
  of
• neurons (nerve cells that make up the brain)
• spinal cord
• nerves

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Orderly Function of the Nervous System (contd.)

• The nervous system is composed of two divisions
• central nervous system (brain and spinal cord)
• peripheral nervous system (nerves that radiate
  from the spinal cord throughout the body)

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Orderly Function of the Nervous System (contd.)

• Peripheral nervous system is divided into two
  parts
• sympathetic
• parasympathetic
• together, these regulate the voluntary (muscle
  movements) and involuntary (heart rate) functions
  of the body

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The Peripheral Nervous System
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Orderly Function of the Nervous System (contd.)

• The nervous system is susceptible to various
  problems
• vascular compromise and circulatory deficits
• injury
• infection
• inherited defect
• congenital defect
• degeneration
• tumor

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Neurologic Assessment

• There is a variety of methods to evaluate
  neurologic status and cognitive function.
• Take thorough medical history, including any
  medications.
• Test mental functions (speech, language, and
  writing skills).
• Test cranial nerve function (sense of smell,
  vision, taste, hearing, swallowing, etc.).
• Test motor function (muscle strength and tone).
• Test coordination and balance.
• Test sensory function (diminished or abnormal
  sensation).

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Vascular DisordersCerebrovascular Accident
(Stroke)

• A cerebrovascular accident (CVA) occurs when the
  brain is damaged by a sudden disruption in the
  flow of blood to a part of the brain or by
  bleeding inside the head.

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Cerebrovascular Accident (Stroke) (contd.)
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Cerebrovascular Accident (Stroke) (contd.)

• Common symptoms include sudden
• severe headache
• partial or total loss of the ability to
  articulate ideas or comprehend spoken or written
  language (aphasia)
• weakness (hemiparesis), numbness, or paralysis
  (hemiplegia), confusion, or impaired
  consciousness
• loss or blurring of vision, double vision
  (diplopia)
• dizziness, loss of balance or coordination

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Cerebrovascular Accident (Stroke) (contd.)

• Causes
• a CVA is usually a result of one of three types
  of vascular disorders
• blood clot (cerebral thrombosis)
• cerebral hemorrhage
• cerebral embolism
• artery blockage (atherosclerosis) or hypertension
  (high blood pressure)

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Cerebrovascular Accident (Stroke) (contd.)

• Treatment
• immediate medical intervention within three hours
  of stroke may limit brain damage. It includes
• immediately chewing an aspirin
• anticoagulants (to prevent clotting of blood)
• surgery to improve circulation and remove clots

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Cerebrovascular Accident (Stroke) (contd.)

• Prevention
• Known risk factors include
• smoking
• excesses in diet and alcohol consumption
• high blood pressure
• diabetes

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Transient Ischemic Attack

• Transient ischemic attacks (TIAs) are temporary
  episodes of impaired neurologic functioning
  caused by an inadequate flow of blood to a
  portion of the brain.

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Transient Ischemic Attack (contd.)

• Symptoms
• sudden weakness or numbness down one side of body
  (hemiparesis)
• dizziness
• dysphagia
• confusion

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Transient Ischemic Attack (contd.)

• Diagnosis
• history and physical examination
• cranial MRI scan
• CT scan
• EEG

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Transient Ischemic Attack (contd.)

• Treatment
• aspirin (as soon as symptoms appear)
• anticoagulants
• surgery (if needed to increase blood flow to the
  affected area)

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Head TraumaEpidural and Subdural Hematomas

• An epidural hematoma is a mass of blood that
  forms between the skull and the dura mater, the
  outermost of the three membrane layers that cover
  the brain.
• A subdural hematoma is a similar mass, but it
  forms beneath the dura mater.

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Epidural and Subdural Hematomas (contd.)
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Epidural and Subdural Hematomas (contd.)

• Symptoms usually appear within a few hours of
  head trauma and include
• sudden headache
• dilated pupils
• nausea and vomiting
• increased drowsiness
• slight paralysis or weakness affecting one side
  of the body (hemiparesis)

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Epidural and Subdural Hematomas (contd.)

• Treatment
• If consciousness is lost, a craniotomy (burr hole
  drilled in the skull to relieve pressure) might
  be necessary.
• If patient is conscious, medical attention should
  be sought immediately.

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Cerebral Concussion

• A concussion is bruising of the cerebral tissue
  that is caused by violent back and forth movement
  of the head.
• Blunt force trauma may also cause this condition.
• A concussion causes a disruption of normal
  electrical activity in the brain, but the brain
  itself usually is not injured.

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Cerebral Concussion (contd.)

• Symptoms
• immediate loss of consciousness
• can be followed by a period of amnesia
• shallow respiration
• slower pulse
• muscle tone flacid
• Upon gaining consciousness, patient might
  experience
• headache
• nausea/vomiting
• blurred vision
• sensitivity to light (photophobia)

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Cerebral Concussion (contd.)

• Diagnosis
• complete neurological examination
• CT scan
• Treatment
• bed rest
• observation for behavioral changes

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Cerebral Contusion

• Contusion involves bruising the tissues along or
  just beneath the surface of the brain.
• A contusion is more serious than a concussion.

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Cerebral Contusion (contd.)

• Symptoms
• vary according to site and extent of injury and
  persist more than 24 hours
• range from temporary consciousness to coma
• when conscious
• severe headache
• slight paralysis or weakness affecting one side
  of the body
• drowsiness, lethargy, combative mood

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Cerebral Contusion (contd.)

• Diagnosis
• a complete neurological examination
• CT scan
• Treatment
• hospitalization so vital signs can be monitored

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Depressed Skull Fracture

• A fractured skull occurs when a break or fracture
  occurs in one of the bones of the cranium.
• When one or more of these skull bones are
  depressed or torn loose, they are pushed below
  the normal surface of the skull.

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Depressed Skull Fracture (contd.)
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Depressed Skull Fracture (contd.)

• Symptoms
• varies based upon site of fracture
• typically not progressive, but static until bone
  causing pressure is removed

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Depressed Skull Fracture (contd.)

• Treatment
• focused on relieving intracranial pressure,
  usually by performing a craniotomy to raise the
  depressed bone to its original place
• head protection worn until the fracture at least
  partially healed

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Spinal Cord Injuries Paraplegia and Quadriplegia

• Paraplegia is the loss of nerve function below
  the waist and results in paralysis of the lower
  trunk and legs.
• Quadriplegia is the loss of nerve function below
  the cervical region, resulting in paralysis of
  arms, hands, trunk, and legs.

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Paraplegia and Quadriplegia (contd.)

• Symptoms
• Paraplegia
• loss of motor and sensory control in lower
  extremities and trunk
• loss of bladder, bowel, and sexual function
• Quadriplegia
• loss of motor and sensory control in upper and
  lower body
• low blood pressure (hypotension)
• high body temperature (hyperthermia)
• slow heart rate (bradycardia)
• respiratory problems

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Paraplegia and Quadriplegia (contd.)

• Causes
• compression of vertebrae
• Trauma to the thoracic and lumbar regions of the
  spine (T1 and below) usually results in
  paraplegia.
• hyperflexion of neck
• Trauma to the cervical vertebrae (C5 or above)
  can result in quadriplegia.
• hyperextension of spine
• Trauma occurring above C3 is usually fatal.

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Spinal Injuries (contd.)
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Paraplegia and Quadriplegia (contd.)

• Diagnosis
• complete assessment of neurologic functioning
• spinal radiographic films
• MRI scans
• CT scans

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Paraplegia and Quadriplegia (contd.)

• Treatment
• Main goals
• restoration of normal alignment and stability of
  spine
• decompression of the spinal cord, nerves, and
  vertebrae
• early rehabilitation
• Surgery
• Medications

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Chapter 13Lesson 13.2
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Intervertebral Disk DisordersDegenerative Disk
Disease

• Intervertebral disks are located between the
  vertebrae.
• The degeneration is usually the result of
  constant wearing on the disk through misalignment.

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Degenerative Disk Disease (contd.)

• Symptoms
• pain that radiates down the nerve path
• burning
• can include loss of motor function in the legs
• numbness and associated weakness of the legs

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Degenerative Disk Disease (contd.)

• Diagnosis
• Various imaging
• MRI scan
• myelogram with contrast
• rarely CT scan

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Degenerative Disk Disease (contd.)

• Treatment
• resting back and lower extremities
• bracing back
• analgesics, NSAIDs
• surgical intervention might be necessary (spinal
  fusion, freeing trapped nerves).
• severe cases electrical stimulation of the skin
  to relieve pain or a continuous flow of morphine

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Herniated and Bulging Disk

• A herniated disk is a rupture of the nucleus
  pulposus, an elastic pulpy mass lying in the
  center of each intervertebral cartilage, which is
  housed in a circular wall structure (annulus).
• When the nucleus pulposus extends into the inner
  annulus only, it is considered a bulging disk.
• When the nucleus pulposus extends through the
  inner and outer annulus, it is considered a
  herniated disk.

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Herniated and Bulging Disk (contd.)
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Herniated and Bulging Disk (contd.)

• Symptoms
• Patient experiences severe back pain.
• Pain may radiate from back to buttocks, thigh,
  and leg.
• Possible disability can occur if disk pinches or
  pushes against spinal nerves.

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Herniated and Bulging Disk (contd.)

• Causes
• sudden impact
• improper body mechanics when lifting
• poor posture
• aging (can cause disk to degenerate)

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Herniated and Bulging Disk (contd.)

• Treatment (conservative)
• bed rest for 24 to 48 hours
• hot and cold packs
• muscle relaxants
• analgesics
• back brace
• Treatment (advanced)
• Surgical excision of the herniated disk or
  related procedures to relieve the pressure
  against the spinal cord

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Sciatic Nerve Injury Spinal Stenosis

• Spinal stenosis is brought about by trauma,
  degeneration, or rupture of the nucleus pulposus
  within intervertebral disks L4 through S1 (lower
  back).
• The degeneration or rupture exerts pressure
  directly on the sciatic nerve, sending impulses
  down into the leg.

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Sciatic Nerve Injury Spinal Stenosis (contd.)
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Sciatic Nerve Injury Spinal Stenosis (contd.)

• Symptoms
• sharp, radiating pain from the sciatic nerve down
  the leg and to the foot
• numbness
• pain in lower back, buttocks, thighs, or calves
• inability to sit or stand

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Sciatic Nerve Injury Spinal Stenosis (contd.)

• Treatment
• bed rest for 24 to 48 hours
• back brace
• strengthening core muscles (after inflammation
  subsides)
• medications (analgesics, muscle relaxants,
  anti-inflammatories, and, in some cases,
  narcotics)
• physical therapy
• surgical intervention (partial or complete
  removal might be necessary in some cases)

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Functional Disorders Headache

• A pain located in the head that is not confined
  to any one specific nerve area
• Two physiologic causes
• Tension headache results from strain on facial,
  neck, and scalp muscles.
• Vascular headache is brought on when excess fluid
  in the blood vessels of the head causes the
  vessels to change in size.

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Functional Disorders Headache (contd.)

• Symptoms
• Pain may vary from dull to severe, be constant or
  intermittent, and have a throbbing, pressure, or
  penetrating sensation.
• This may signal an underlying disorder or disease
  (hypertension, stroke, brain tumor, or
  encephalitis) but in most cases does not.

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Functional Disorders Headache (contd.)

• Treatment
• If no underlying cause is found, the typical
  treatment includes
• analgesics
• muscle relaxants
• minor tranquilizers
• muscle massage
• warm bath

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Migraine

• periodic severe headaches that may completely
  incapacitate the individual and are almost always
  accompanied by other symptoms

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Migraine (contd.)

• Symptoms
• bilateral throbbing pain
• nausea
• vomiting
• visual auras (zigzagging lines, flashing lights)
• high sensitivity to light

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Migraine (contd.)

• Treatment
• bed rest in a quiet, dark room
• analgesics
• drug therapy (vasoconstrictors) to constrict
  blood vessels
• antiemetics (to control vomiting)
• relaxation therapy
• biofeedback

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Epilepsy

• a chronic brain disorder characterized by sudden
  episodes of abnormal intense electrical activity
  in the brain, which results in seizures
• Epileptic seizures are classified as either
• partial
• generalized

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Epilepsy (contd.)

• Symptoms
• partial seizure can involve motor movement, such
  as
• rhythmic twitching
• compulsive lip smacking
• picking at clothing
• sensory auras
• amnesia of the attack

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Epilepsy (contd.)

• Symptoms (contd.)
• generalized seizures include
• absence attacks (also called petit mal)
  characterized by frequent but transient lapses of
  consciousness and only rare spasms
• tonic-clonic attacks (also called grand mal)
  severe form of epilepsy characterized by seizures
  involving spasms and loss of consciousness

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Epilepsy (contd.)

• Causes
• pathologic conditions associated with seizure
  include
• scar tissue on the cerebral cortex from infection
  or trauma
• tumor of the cerebral cortex
• cerebral edema
• stroke
• birth trauma (cerebral palsy)
• drug toxicity (alcoholism)

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Epilepsy (contd.)

• Treatment
• anticonvulsive medications
• surgical intervention (rare) to remove a lesion
  in the brain

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Epilepsy (contd.)

• First aid for seizures
• Do
• Cushion head.
• Loosen tight neckwear.
• Turn person to the side.
• Look for identification.
• Dont
• Put anything in mouth.
• Hold person down.

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Parkinson Disease

• a slowly progressive neurologic disorder that is
  linked to decreased dopamine production in the
  brain and is characterized by tremor, weakness of
  resting muscles, and a shuffling gait

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Parkinson Disease (contd.)

• Symptoms
• stooped posture
• shuffling gait
• head bowed, body flexed forward, prone to falling
• pill-rolling (tremor of the thumb and
  forefinger)
• expressionless facial features
• muffled speech
• difficulty swallowing

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Parkinson Disease (contd.)

• Treatment
• no cure known managing symptoms only
• physical therapy
• drug therapy
• levodopa and carbidopa (drugs the body converts
  to dopamine)
• antidepressants
• anticholinergics (for tremor and rigidity)

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Huntington Chorea

• a hereditary degenerative disease of the cerebral
  cortex and basal ganglia (mass of gray matter at
  the base of the cerebral hemisphere), which
  causes progressive atrophy of the brain

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Huntington Chorea (contd.)

• Symptoms
• loss of musculoskeletal control (mild fidgeting
  to lip smacking)
• speech difficulties
• deterioration of emotional state (personality
  changes, moody behavior, loss of memory,
  paranoia, dementia)

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Huntington Chorea (contd.)

• Treatment
• Since no cure is known, treatment focuses on
  symptom control of erratic movement and agitation
  through drug therapy.
• Eventually, residential care could be necessary.

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Amyotrophic Lateral Sclerosis

• also known as Lou Gehrig disease, a progressive
  motor neuron disease that results in motor atrophy

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Amyotrophic Lateral Sclerosis (contd.)

• Symptoms
• initially, small, involuntary contractions
  (fasciculations) of the forearms and hands
• as disease progresses, muscle atrophy sets in and
  creates difficulties with
• speech
• swallowing
• chewing
• breathing

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Amyotrophic Lateral Sclerosis (contd.)

• Treatment
• Since no cure is known, treatment is directed at
  controlling symptoms through drug therapy,
  maintaining pulmonary function, and providing
  supportive services.

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Transient Global Amnesia

• a temporary amnesia of short duration (several
  hours) that is marked by sudden onset, loss of
  recent memories, and an inability to form new
  memories

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Transient Global Amnesia (contd.)

• Symptoms
• sudden onset of memory loss (includes current and
  recent events but not self-identity)
• confusion
• repetitive questioning (Where am I?, etc)
• no recollection of events of past few hours or
  possibly days when amnesia period ends

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Transient Global Amnesia (contd.)

• Cause is uncertain.
• Suspected links
• stress or emotional events
• swimming or immersion in cold water
• previous migraine headache
• Prognosis is good recurrence very unlikely.

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Chapter 13Lesson 13.3
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Peripheral Nerve Disorders Peripheral Neuritis

• degeneration of the peripheral nerves that extend
  to the extremities, leading to muscle weakness
  and sensory loss

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Peripheral Neuritis (contd.)

• Can be caused by
• chronic alcohol use
• infectious diseases (mumps, pneumonia,
  diphtheria)
• toxicity from various substances (arsenic, lead,
  etc.)
• metabolic or inflammatory diseases (diabetes,
  rheumatoid arthritis, gout, lupus)
• nutritional deficiency diseases

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Peripheral Neuritis (contd.)

• Symptoms
• clumsiness
• loss of sensation in hands and feet
• wasting of muscle tone
• glossy or red appearance to skin
• decreased sweating
• possible foot drop

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Peripheral Neuritis (contd.)

• Treatment
• eliminate exposure to toxic substances
• correct any nutritional deficiencies
• control underlying diseases
• stop alcohol consumption (if applicable)
• physical therapy
• analgesics

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Trigeminal Neuralgia (Tic Douloureux)

• Pain originates from fifth cranial nerve, also
  called the trigeminal nerve.
• Most cases have no identified cause, but
  occasionally the condition is related to tumor,
  compression of a nerve, multiple sclerosis, or
  shingles.

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Trigeminal Neuralgia (Tic Douloureux) (contd.)
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Trigeminal Neuralgia (Tic Douloureux) (contd.)

• Symptoms
• sudden onset of excruciating pain that may affect
  one or more nerve branches
• ophthalmic branch causes pain in the eye and
  forehead
• maxillary branch involves the nose, upper lip,
  and cheek
• mandibular branch affects lower lip and outer
  portion of the tongue and cheek near the ear

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Trigeminal Neuralgia (Tic Douloureux) (contd.)

• Treatment
• analgesics for pain
• surgical intervention might be necessary to
  dissect nerve roots.
• cessation of smoking (if applicable)

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Bell Palsy

• disorder of the facial nerve that causes a sudden
  onset of weakness or paralysis of facial muscles
• can result from blockage of impulses from the
  facial nerve caused by compression of the nerve

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Bell Palsy (contd.)

• Symptoms (usually unilateral)
• pain or drawing sensation behind the ear
• inability to open or close the eye
• drooping of mouth
• drooling of saliva
• distorted facial expression

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Bell Palsy (contd.)

• Treatment
• warm, moist gentle heat
• massage
• facial exercises
• prednisone (synthetic steroid) to reduce edema of
  facial nerve
• analgesics
• electrotherapy to stimulate nerves and prevent
  atrophy of muscles

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Trigeminal Neuralgia and Bell Palsy
Compare/Contrast

• Similarities
• both caused by disorder of facial nerve
• sudden onset
• unilateral

Differences Trigeminal extreme pain no motor
function impairment prognosis varies

• Bell Palsy
• sudden paralysis
• motor function impaired
• prognosis is good if treated early

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Infectious Disorders Meningitis

• inflammation of the meninges, the membranous
  coverings of the brain, and the spinal cord

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Infectious Disorders Meningitis (contd.)

• Symptoms
• vomiting
• headache that increases in intensity with
  movement or shaking of head
• neck stiffness (nuchal rigidity)
• drowsiness
• irritability
• high sensitivity to light (photophobia)
• hypersensitivity of the skin

98
Infectious Disorders Meningitis (contd.)

• Diagnosis
• includes a lumbar puncture to determine if
  cerebrospinal fluid (CSF) has increased levels of
  white blood cells, protein, and glucose
• if so, resulting growth of microbes in cultured
  CSF confirms diagnosis

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Infectious Disorders Meningitis (contd.)

• Treatment
• aggressive antibiotic therapy
• anticonvulsive drugs to control seizure activity
• aspirin or acetaminophen for headache
• dark and quiet environment

100
Encephalitis

• Encephalitis is an inflammation of the brain that
  leads to cerebral edema and subsequent cell
  destruction.
• Most cases are the result of a bite from an
  infected mosquito.
• Can also be caused by viruses or the toxins from
  chickenpox, measles, or mumps.

101
Encephalitis (contd.)

• Symptoms
• headache
• elevated body temperature
• neck and back stiffness
• muscular weakness
• restlessness
• visual disturbances
• lethargy
• mental confusion that may progress to
  disorientation and even to coma

102
Encephalitis (contd.)

• Diagnosis
• blood tests
• cerebrospinal fluid sample
• EEG

103
Encephalitis (contd.)

• Treatment
• antiviral agents effective against herpes simplex
  encephalitis.
• otherwise
• mild analgesics for pain
• anticonvulsive
• antibiotics for any present infection

104
Guillain-Barré Syndrome

• An acute, rapidly progressive disease of the
  spinal nerves
• This condition is thought to have an autoimmune
  basis and has been known to follow a respiratory
  infection or gastroenteritis.

105
Guillain-Barré Syndrome (contd.)

• Symptoms
• tingling and numbness of feet and hands at onset
  of disease
• followed by
• increasing muscle pain and tenderness
• progressive muscle weakness
• paralysis
• difficulty swallowing

106
Guillain-Barré Syndrome (contd.)

• Treatment
• hospitalization required for observation
• blood plasma washed to remove antibodies (called
  plasmapheresis) and speed recovery

107
Brain Abscess

• a collection of pus anywhere in the brain tissue
• can be caused by a local infection or secondary
  infections elsewhere in the body

108
Brain Abscess (contd.)

• Symptoms
• headache (prime symptom)
• other symptoms depend on location and extent of
  abscess, amount of cranial pressure, and can
  include
• nausea and vomiting
• visual disturbances
• unequal pupil size (anisocoria)
• seizures

109
Brain Abscess (contd.)

• Treatment
• intravenous antibiotics
• mannitol or steroids to reduce cerebral edema
• surgical drainage of abscess to relieve pressure

110
Poliomyelitis and Postpolio Syndrome

• Poliomyelitis is a viral infection of the gray
  matter of the spinal cord that causes a selective
  destruction of the motor neurons.
• Postpolio syndrome is a condition affecting
  poliomyelitis patients several decades after the
  initial attack, characterized by fatigue,
  muscular deterioration, pain in the joints, and
  respiratory problems.

111
Poliomyelitis and Postpolio Syndrome (contd.)

• Symptoms
• low-grade fever
• profuse discharge from nose
• malaise
• these symptoms are followed by
• muscle weakness
• stiff neck
• nausea and vomiting
• atrophy of muscles
• muscle and joint deterioration

112
Poliomyelitis and Postpolio Syndrome (contd.)

• Treatment
• analgesics
• moist heat
• bed rest
• physical therapy
• leg braces
• mechanical ventilation

113
Intracranial Tumors (Brain Tumors)

• These tumors can be primary (originate in the
  brain itself) or secondary (cancer that has
  metastasized from another area of the body).

114
Intracranial Tumors (Brain Tumors) (contd.)

• Symptoms result from a displacement and
  compression of normal brain tissue by the tumor
  and include
• headache (usually dull, constant, and worse at
  night or in the morning)
• seizures
• nausea and vomiting
• loss of consciousness
• cognitive dysfunction (memory problems and
  personality changes)

115
Intracranial Tumors (Brain Tumors) (contd.)

• Diagnosis
• detailed history
• neurologic examination
• diagnostic imaging studies
• cranial MRI (preferred option)
• functional MRI
• tissue sample (from surgery or biopsy)

116
Intracranial Tumors (Brain Tumors) (contd.)

• Treatment primary tumors
• benign and malignant tumors often treated
  similarly
• surgery
• radiotherapy
• chemotherapy
• anticonvulsants to treat seizures
• corticosteroids to help decrease intracranial
  pressure
• anticoagulants to prevent blood clotting

117
Intracranial Tumors (Brain Tumors) (contd.)

• Treatment secondary tumors
• focuses on relief of neurological symptoms and
  long-term tumor control
• patients with solitary brain lesions and no other
  sites of metastasis undergo
• surgery
• whole brain radiation therapy

118
Intracranial Tumors (Brain Tumors) (contd.)

• Prognosis
• The five-year survival rate for all types of
  brain tumors combined is 32, which is among the
  lowest for all types of cancer.