Astrocytoma physical examination
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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
Physical Examination
NOTE: Based on the location of the tumor,we might have different signs and symptoms.
Appearance of the Patient
- Patients are usually well appearing and can have gait disturbances[1]
Vital Signs
Tumors which are located in the brain stem can cause heart rate and blood pressure disturbance:[2]
- Tachycardia or bradycardia
- Orthostatic hypotension
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 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.