Brain metastases

Question 1

What is brain metastases?

Answer 1

Most common cause of brain tumours in adults

• Tumours that most commonly spread to the brain → lung cancer (most common), breast cancer, colorectal cancer, testicular cancer

Question 2

What are the presenting symptoms of a brain metastases?

Answer 2

1. Headaches (persistent) → worse in the mornings and when lying down (=raised ICP) = Spaceo occupying lesion
2. Seizures
3. Focal Neurological Deficits → ie. changes in speech, vision and hearing
4. Cognitive Deficits

Question 3

What are the risk factors for brain metastases?

Answer 3

Lung cancer is the most common cause

Question 4

What investigations are used to diagnose/ monitor brain metastases?

Answer 4

Imaging (CT/MRI)→ can see well-circumscribed tumours at the junction of gray and white matter

Question 5

How is brain metastases managed?

Answer 5

1. 1st Line → high-dose dexamethasone (reduces cerebral oedema)
2. Limited brain metastases → surgical resection
3. Extensive brain metastases → stereotactic radiosurgery, whole-brain radiation therapy, or chemotherapy

Question 6

Describe the prognosis of brain metastases

Answer 6

Mean survival ∼1 month without treatment, and <1 year with treatment