Intracranial mass: Difference between revisions
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==Clinical Features== | ==Clinical Features== | ||
*Vary depending on size, location, and nature of mass | |||
{{HA red flags}} | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
Latest revision as of 03:32, 3 October 2019
Background
Clinical Features
- Vary depending on size, location, and nature of mass
Headache Red Flags
Features
- Sudden onset or accelerating pattern
- Maximum intensity of pain at onset (i.e. "thunderclap")
- Worse with valsalva
- Worse in the morning or at night
- No similar headache in past
- Age >50 yr or <5 yr
- Occipitonuchal headache
- Visual disturbances
- Exertional or postcoital
- Family or personal history of SAH, cerebral aneurysm, or AVM
- Focal neurologic signs
- Diastolic BP >120
- Papilledema
- Jaw claudication
Clinical Context
Headache in setting of:
- Infection
- Cancer
- Immunosuppression
- Seizure
- Syncope
- Trauma
- Altered mental status
- Systemic illness (fever, stiff neck, rash)
- Nausea/vomiting
- Patient on anticoagulation, steroids, NSAIDs, antiplatelet
Differential Diagnosis
Intracranial Mass
- Intracranial hemorrhage
- Intra-axial
- Hemorrhagic stroke (Spontaneous intracerebral hemorrhage)
- Traumatic intracerebral hemorrhage
- Extra-axial
- Epidural hemorrhage
- Subdural hemorrhage
- Subarachnoid hemorrhage (aneurysmal intracranial hemorrhage)
- Intra-axial
- Brain tumor
- Brain abscess
- Subdural empyema
- Epidural abscess (intracranial)
Workup
Management
- Treat specific process
- Consider seizure prophylaxis
- See also Management of Elevated Intracranial Pressure