4-2009

.: Дата публікації 2010-01-18 :: Переглядів: 5 :: :.

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Cerebral metastatic disorder diagnostics peculiarities
S.I. SHKROBOT, N.R. SOKHOR, O.Yu. BUDARNA, L.V. SHKROBOT, O.R. YASNIY

Objective – to clarify the role of clinical-paraclinical methods of examination in patients with brain metastasis
Methods and subjects. 20 patients with brain metastasis were observed. All of patients were carefully examined, including peculiarities of anamnesis, onset of the disease, clinical signs, dates of general clinical and additional methods of diagnosis: CT-scan and MRI, EEG, brain ultra sound, X-ray of abdominal cavity, CT-scan of inner organs.
Results. It is found that brain metastasis in elderly and senior patients usually has atypical course of the disease with clinical signs of acute or chronic disturbances of cerebral blood circulation, that covered the symptoms of primary focus. 3 patients had oncologic anamnesis. In 9 patients brain metastasis was diagnosed on CT-scan without contrasting. In 6 cases lung tumor was observed on X-ray. 2 patients had liver, 5 persons had uterus, ovaries and thyroid gland metastasis. Ultra sound of brain vessels described nonadequate changes of vascular region compared with neurological deficiency. Nonspecific changes on EEG dominated, except 3 patients with seizures. In half of cases were nontypical for vascular process changes in general blood analysis. Optic disc edema was diagnosed in quarter of patients. Primary focus was found only in half of patients after analysis of additional methods of diagnostics.
Conclusions. These results allow us to specify the clinical-paraclinical peculiarities of brain metastasis. To suspect brain metastasis one should pay attention to oncological anamnesis, slow development of the disease; presence of convulsive syndrome; absence of marked cardio-vascular pathology; disparity of ultra sound changes with neurological deficit in patients; presence of «small signs» of tumours.