Astrocytoma physical examination: Difference between revisions
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{{CMG}}; {{AE}} {{Fs}} | {{CMG}}; {{AE}} {{Fs}} | ||
==Overview== | ==Overview== | ||
Common physical examination findings of astrocytoma include [[gait]] disturbances, [[Tachycardia]] or [[bradycardia]], [[Orthostatic hypotension]], reduced hearing acuity, [[nystagmus]], abnormal extra-ocular movement, nonreactive [[Pupil|pupils]], [[papilledema]], [[blurry vision]], head tilt, [[Altered mental status]], [[Clonus]] , [[Hyperreflexia]], [[Muscle rigidity]], proximal/distal muscle weakness unilaterally or bilaterally, [[Cranial nerves|cranial nerve]] involvement , unilateral/bilateral sensory loss in the upper/lower extremity, positive [[Trendelenburg's sign]], unilateral/bilateral [[tremor]] and [[Dysmetria]]. | |||
==Physical Examination== | ==Physical Examination== | ||
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=== Appearance of the Patient === | === Appearance of the Patient === | ||
* Patients are usually well appearing and can have [[gait]] disturbances<ref name="pmid21721894">{{cite journal| author=Forbes JA, Mobley BC, O'Lynnger TM, Cooper CM, Ghiassi M, Hanif R et al.| title=Pediatric cerebellar pilomyxoid-spectrum astrocytomas. | journal=J Neurosurg Pediatr | year= 2011 | volume= 8 | issue= 1 | pages= 90-6 | pmid=21721894 | doi=10.3171/2011.4.PEDS1115 | pmc=PMC3779306 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21721894 }} </ref> | * Patients are usually well appearing and can have [[gait]] disturbances.<ref name="pmid21721894">{{cite journal| author=Forbes JA, Mobley BC, O'Lynnger TM, Cooper CM, Ghiassi M, Hanif R et al.| title=Pediatric cerebellar pilomyxoid-spectrum astrocytomas. | journal=J Neurosurg Pediatr | year= 2011 | volume= 8 | issue= 1 | pages= 90-6 | pmid=21721894 | doi=10.3171/2011.4.PEDS1115 | pmc=PMC3779306 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21721894 }} </ref> | ||
=== Vital Signs === | === Vital Signs === | ||
Latest revision as of 17:14, 14 January 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Fahimeh Shojaei, M.D.
Overview
Common physical examination findings of astrocytoma include gait disturbances, Tachycardia or bradycardia, Orthostatic hypotension, reduced hearing acuity, nystagmus, abnormal extra-ocular movement, nonreactive pupils, papilledema, blurry vision, head tilt, Altered mental status, Clonus , Hyperreflexia, Muscle rigidity, proximal/distal muscle weakness unilaterally or bilaterally, cranial nerve involvement , unilateral/bilateral sensory loss in the upper/lower extremity, positive Trendelenburg's sign, unilateral/bilateral tremor and Dysmetria.
Physical Examination
NOTE: Based on the location of the tumor,we might have different signs and symptoms.
Appearance of the Patient
Vital Signs
Tumors which are located in the brain stem can cause heart rate and blood pressure disturbance:[2]
Skin
- Skin examination of patients with astrocytoma is usually normal.
HEENT
- Hearing acuity may be reduced
- Nystagmus may be present
- Extra-ocular movements may be abnormal
- Pupils may not react to light
- Ophthalmoscopic exam may be abnormal with findings of papilledema such as swollen disc, blurry vision, venous engorgement.
Neck
- Head tilt may be present[3]
Lungs
- Pulmonary examination of patients with astrocytoma is usually normal.
Heart
- Cardiovascular examination of patients with astrocytoma is usually normal.
Abdomen
- Abdominal examination of patients with astrocytoma is usually normal.
Back
- Back examination of patients with astrocytoma is usually normal.
Genitourinary
- Genitourinary examination of patients with astrocytoma is usually normal.
Neuromuscular
- Patient is usually oriented to persons, place, and time
- Altered mental status
- Glasgow coma scale is 15 / 15
- Clonus may be present
- Hyperreflexia may be present
- Muscle rigidity
- Proximal/distal muscle weakness unilaterally or bilaterally
- Cranial nerve involvement may be present.
- Unilateral/bilateral sensory loss in the upper/lower extremity
- Abnormal gait may be present (trunkal ataxia)
- Positive Trendelenburg's sign may be present
- Unilateral/bilateral tremor
- Dysmetria may be present[4][5][6]
Extremities
- Extremities examination of patients with astrocytoma is usually normal.
References
- ↑ Forbes JA, Mobley BC, O'Lynnger TM, Cooper CM, Ghiassi M, Hanif R; et al. (2011). "Pediatric cerebellar pilomyxoid-spectrum astrocytomas". J Neurosurg Pediatr. 8 (1): 90–6. doi:10.3171/2011.4.PEDS1115. PMC 3779306. PMID 21721894.
- ↑ Telerman-Toppet N, Vanderhaeghen JJ, Warszawski M (December 1982). "Orthostatic hypotension with lower brain stem glioma". J. Neurol. Neurosurg. Psychiatry. 45 (12): 1147–50. PMC 491700. PMID 7161610.
- ↑ Ansell P, Johnston T, Simpson J, Crouch S, Roman E, Picton S (January 2010). "Brain tumor signs and symptoms: analysis of primary health care records from the UKCCS". Pediatrics. 125 (1): 112–9. doi:10.1542/peds.2009-0254. PMID 20026498.
- ↑ Ansell P, Johnston T, Simpson J, Crouch S, Roman E, Picton S (January 2010). "Brain tumor signs and symptoms: analysis of primary health care records from the UKCCS". Pediatrics. 125 (1): 112–9. doi:10.1542/peds.2009-0254. PMID 20026498.
- ↑ Wilne SH, Ferris RC, Nathwani A, Kennedy CR (June 2006). "The presenting features of brain tumours: a review of 200 cases". Arch. Dis. Child. 91 (6): 502–6. doi:10.1136/adc.2005.090266. PMC 2082784. PMID 16547083.
- ↑ Wilne S, Collier J, Kennedy C, Koller K, Grundy R, Walker D (August 2007). "Presentation of childhood CNS tumours: a systematic review and meta-analysis". Lancet Oncol. 8 (8): 685–95. doi:10.1016/S1470-2045(07)70207-3. PMID 17644483.