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9 Brain Tumors

97

 

 

Extradural tumors

Neuroblastoma

Non-Hodgkin lymphoma

Tumor of the vertebrae: eosinophilic granuloma, Ewing sarcoma (differential diagnosis: hematoma, inflammatory abscess, etc.)

Symptoms:

Compression symptoms: back pain, paraspinal muscle spasm, resistance to

trunk flexion, scoliosis, changes of reflexes, disturbances of walking, sensory deficiencies at dermatome level, decreased perspiration below tumor level, muscle weakness, positive Babinski sign, urinary or anal sphincter impairment (incontinence, urinary retention, obstipation), priapism

The following list summarizes neurological signs, corresponding to different levels of spinal cord tumors

Neurological signs corresponding to different level of spinal cord tumors

C1–C3

Phrenic nerve paralysis (apnea)

C3–C4

Weakness or inability to raise shoulders

C5–C6

Weakness of arm abduction

C7–C8

Weakness of elbow extension, of fingers

T2–T12

Scoliosis, trunk weakness

L1

Weakness of hip flexion

L2

Weakness of hip abduction

L3–L4

Weakness of knee extension

L4–L5

Weakness of abduction and extension as well as dorsal

 

flexion of ankle

L5–S1

Weak hamstrings

S1–S2

Ankle plantar flexion weakness

Tumor in foramen magnum area: stiffness of the neck, torticollis, cervical pain

Tumor in cervical spinal channel: nystagmus

Tumor in cauda equina area: negative reflexes of the lower extremities, muscle atrophy of the legs, urinary and defecation problems

9.7Radiological Diagnosis

9.7.1Magnetic Resonance Imaging (MRI) and Computed Tomography (CT)

MRI and CT are the basic imaging techniques for brain tumors, with demonstration of intracranial structures, lesions, and solid and liquid components

Intravenous application of contrast liquids provides detailed information

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