17:50,15,Jan,2009 | (2218/0/0) | Original
Note: The trackback url will expire after 23:59:59 today
Note: The trackback url will expire after 23:59:59 today
Brain tumors associated with mental disorders worry about 4 minutes (content expertise) to edit entries summary
There is no summary of the contents of the directory welcome to add the edit summary - [hide] 1 Overview 2 Etiology 3 Symptoms 4 Treatment of editing this section | Back to top Overview
Brain tumors associated with mental disorders is the oppression of intracranial tumor invasion of adjacent brain parenchyma or cerebral blood vessels in brain tissue, causing substantial damage to the brain or increased intracranial pressure associated with mental disorders, patients suffering from brain tumor about 40% 100% of the psychiatric symptoms may occur. Edit this section | Back to the top of the etiology
Mental disorders due to brain tumor symptoms and some features are closely related to the following aspects
1. Frontotemporal tumor site psychiatric symptoms of their tumor were significantly higher than other parts of the tumor temporal lobe tumor visual hallucinations often appear tumors often show frontal and verbal antics of tumor in the left hemisphere or right hemisphere of the psychiatric symptoms there are also differences in the impact of
2. Brain tumor histological type and growth rate of rapid growth with increased intracranial pressure were more acute organic brain syndrome; chronic growth of the tumor easily lead to cognitive impairment or focal neurological symptoms of slow-growing tumors lead to loss of cognitive intelligence prior to the onset of defects and related
3. Tumor size, the greater the volume of the more obvious symptoms of
4. Premorbid functional status
5. Brain tumor surgery
Overall brain tumor with a variety of mental disorders due to a combination of factors related to
(B) of the pathogenesis
1. Psychotic symptoms in the form of intracranial tumors in the form of mental disorder due to basically be divided into five kinds: directly or indirectly caused by the tumor itself; tumor caused epilepsy and showed the spirit of attack; patients tumors and (or) the occurrence of surgical psychotic reaction; of poor quality were induced affective disorders such as schizophrenia; of organic injury compensation
(1) directly or indirectly caused by the tumor itself:
â‘ the site of tumor is closely associated with mental function, such as temporal lobe frontal limbic system of the corpus callosum and other easy-psychiatric symptoms
â‘¡ brain tumor expansion because of increased intracranial pressure caused by the growth of about 80% of patients had intracranial tumors increased intracranial pressure caused by increased intracranial pressure following reasons: the tumor in the cranial cavity to occupy a certain volume of space can be met or exceeded the body on behalf of compensation limit (about the cranial cavity volume of 8% to 10%), increased intracranial pressure appears; tumor obstruction of cerebrospinal fluid circulation path or for any part
These factors interact to form a vicious cycle of increased intracranial pressure caused by increased intracranial pressure more and more severe psychiatric symptoms, including neurological disease-like symptoms and mental excitement or depression group main symptom clusters
â‘¢ rapid tumor growth of malignant tumors such as pleomorphic glioblastoma itself can soften the necrotic tissue around the hemorrhage and edema and necrosis of the high degree of psychiatric symptoms caused by invasive easy
â‘£ brain tumors associated with the degree of brain edema, such as the rapid development of metastatic brain cancer and malignant tumors are often associated with severe psychiatric symptoms of cerebral edema prone
In short generally associated with rapid growth and increased intracranial pressure brain tumors showed acute organic syndrome and slow growth of the tumor easily lead to cognitive deficits, although this type of mental disorder, directly or indirectly caused by the tumor itself but also by the personality of the patient
(2) tumor caused by epilepsy and mental performance of seizures: seizures are common symptoms of brain tumor patients with intracranial tumors account for about 30% to 40% of episodes of seizures as the initial symptom of intracranial tumors accounted for 10.3% ( ZHANG Xin Bao, etc. 1986), in particular meningiomas star of glioblastoma multiforme glioblastoma brain tumor and other violations of the limbic system, there may be temporal lobe seizures, that is the spirit of the spirit of the onset of symptomatic form of epilepsy is difficult to draw boundaries, however during epileptic seizures be caused by intrinsic tumor activity but also affect how the spirit of both cancer and epilepsy, where the emergence of mental disorders need further study
(3) patients after resection of intracranial tumors and psychotic reactions have occurred:
â‘ the spirit of intracranial tumors reaction: This type of response depends on the attitude of cancer patients with other somatic disease with psychotic reactions and treatment of cancer patients as too concerned about the prospects for further development of mechanisms for the occurrence of paranoid intention of shirking on health care staff and family members suspected to be hostile to him together with delays in diagnosis and treatment
â‘¡ intracranial tumor surgery a transient psychotic reactions: Nanjing nervous mental diseases hospital from 4 patients with mental disorders due to intracranial tumors in 2 patients after surgery, Department of psychotic reaction in which the right parietal and right frontal meningioma meningiomas The 1 Xu Min-hui (1990) reported posterior fossa tumors after surgery a transient mental disorders in 7 cases in which ependymoma 1 meningioma 1 acoustic neuroma 3 epithelial cyst 1 medulloblastoma 1 or more groups cases were occurred after 1 week up to 3 weeks minimum 2 days in all cases there was no family history of clinical psychiatric symptoms in the excitement and paranoid easy to control with neural blockade onset of increased intracranial pressure without CSF expression and tumor pathology has nothing to do
Intracranial tumor, whether before or after surgery or surgery in most patients the tumor was caused brain damage which led to great concern and behavioral responses that were similar to the performance of disaster response is easy patient preoperative anxiety and depression and irritability as tumor growth can occur continuously denied those perceived dysfunction has been very eye-catching signs of their tumors disappear when the anxiety and depression to some extent, these reactions depends on the premorbid personality of patients with previous brain damage adaptation and the speed of previous adaptation to the environment predict their psychological reactions after suffering from cancer patients showed the severity of anxiety and depression is due for its inability to cope with the intellectual challenges of the environment due to continued recession in progress when the spirit of the characteristics of patients response is to deny some patients feel good about the performance of euphoria frivolous meaningless joke and pun (stupid sexual humor witzelsucht)
(4), intracranial tumors induced schizophrenia or affective disorders: schizophrenia that have occurred or emotional disorders are susceptible to intracranial tumors is the quality of brain organic diseases of brain function can be reduced to induce these two types of mental illness than genetic influence, as a general rule any previous brain diseases (including schizophrenia) all contribute to later occurrence of another brain diseases such as encephalitis past there was prone to schizophrenia and vice versa the amount of intracranial tumor invasion of the limbic system parts of the temporal lobe of schizophrenia-like psychosis has been caused by some reports have yet to be confirmed
(5) of the organic defect compensation: incur slow-growing brain tumor and the number of defects in brain function in patients with traumatic brain injury patients as compensation for these defects in behavior can occur if the scourge of the start-like reaction may have performance anxiety, depression, and easy irritation can occur later in patients with traumatic brain injury similar to behavior change
2. Intracranial tumor pathology and psychiatric symptoms and psychiatric symptoms in pathological lack of correlation between the different types of tumors, however changes in the behavior associated with a certain regularity
(1) gliomas: astrocytoma including stellate pleomorphic glioblastoma, medulloblastoma control Nanjing Neuropsychiatric Hospital (1986) confirmed by surgery or pathological examination of 27 cases of intracranial tumors induced mental disorders in patients with meningiomas and gliomas 33.3% 59.2% 7.4% metastasis
â‘ stellate glial cell tumors: Nanjing (1988) 27 cases of intracranial tumor astrocytes tumors in 16 patients (40.7%) stellate glial cell tumors occur in the frontal parietal and temporal lobes showed the limitations of the general growth but also the progress of these tumors were invasive to a quite large before the development of psychiatric symptoms, such as the cerebellum and no violations of children's behavioral change only block the ventricular system as of increased intracranial pressure caused by the beginning of psychiatric symptoms
â‘¡ multiforme glioblastoma: these tumors occur in the rapid development of the frontal parietal and occipital lobe and the tumor tissue and surrounding brain tissue pathological changes in various forms such psychiatric symptoms appeared earlier with a high degree of tumor growth originating in the side of the frontal lobe infiltrating the corpus callosum and quickly spread to the other side of the frontal lobe of their violations can be severe dementia patients multiforme glioblastoma as a violation of the spirit of the temporal lobe symptoms were impaired at this time, as the pathway can be The detection of visual field defects such as damage to the primary side of the temporal lobe is involved in temporal lobe aphasia often have a spiritual seizure onset was sometimes visible barriers to the mandatory automatic thinking, mood disorders illusion illusion-like dream state of automatic reflection performance of the mouth
â‘¢ medulloblastoma: 80% of patients under 15 years old growing in the middle cerebellar ataxia may have headache, nausea and vomiting, increased intracranial pressure, cranial nerve palsy and a small number of patients involved, there may be Dengmu network structure is often misdiagnosed as mental coma Schizophrenia
(2) meningioma: originated in the Department of arachnoid benign meningiomas are slow-growing fibrous structure of the capsule formation occurs in the basal forebrain and the sagittal area next to the growth of large clinical manifestations may be no decrease or only intelligent Meningiomas generally do not cause dementia and this is due to a reduced ability to adapt to the patient through the defense mechanism to compensate for the lack of ability to adapt to occur if the barriers to more patients with tumor volume before the adaptation needs and low levels of disease related
Less likely to cause these tumors to increased intracranial pressure until late in the areas adjacent to the sagittal meningiomas can cause one or both lower limbs were weak or negative economic movement Patton misdiagnosed as hysteria, and Shepherd (1956) pointed out that the meningioma is a mental illness scientists are most interested mostly in the lifetime of a class because of other diseases were not detected until after death was found
(3) pituitary tumors: pituitary tumors can be caused by endocrine disorders or visual impairment staining close to the difficulty of the third ventricle craniopharyngioma pituitary pineal ependymoma tumors can cause significant mental disorders when the first tumor compression third ventricle or worsening symptoms of frontal lobe performance of mental retardation drowsiness no desire concentration difficulties and memory deficit even in a sleepy state of euphoria fictitious patients, such as wake-up appeared to be too easy to irritation adverse events and determine the pituitary tumors seen hallucinations and delusions
(4) nerve sheath tumors: Schwannoma tumor, also known as Schwann cells or nerve sheath tumors in most cases, the capsule is complete with single aneurysm neural adhesion prevalent in the auditory nerve can be seen in the trigeminal nerve of the facial nerve glossopharyngeal nerve and the nerve distribution to the cerebellopontine angle can also occur in up to middle cranial fossa parasellar foramen magnum about 8% of all intracranial tumors 12% of early hearing loss caused by violations of the auditory nerve symptoms such as dizziness and tinnitus and dizziness tumor volume increased involvement of cerebellum and brain stem appeared the performance of even the formation of obstructive hydrocephalus caused by these tumors were few and minor psychiatric symptoms but some patients with auditory nerve sheath tumor reduction in hearing can hear voices on one side
(5) metastatic cancer: malignant brain tumor metastases accounted for 87% of primary tumors in male breast cancer to the lung and the females are the main pathological nature of the progress to adenocarcinoma metastatic to the rapid onset of symptoms from only 3 metastases 6 months the incidence of psychiatric symptoms very high altitude intracranial tumors psychiatric symptoms was 1 / 2 single intracranial metastasis is 1 / 3 of multiple brain metastases is 4 / 5 and diffuse meningeal metastasis cancer was 100% of psychiatric symptoms, including delirium, amnesia, apathy balderdash about the lack of some patients will see no desire stupid euphoria of patients with advanced metastatic carcinoma of humor to the sense of reducing memory loss and confusion no desire indifference directed the development of undesirable drowsiness dementia
3. Of psychiatric symptoms caused by brain tumor factors
(1) Sex and age: Nanjing (1986) 77 male 44 female cases and 33 other domestic data (Luo sincere 1963; Xia Yi Town, 1963) data indicate that female common domestic and international young people 30 to 50-year-old common Law Zhong sincere (1963) had no psychiatric symptoms and behavioral changes in the age groups compared with intracranial tumors found to have the spirit of the age than those without such symptoms were small performance
(2) of disease: refers to the onset to the hospital during the Luo sincere (1963) reported that psychiatric symptoms of patients with intracranial disease was shorter than those without behavioral changes likely to cause psychiatric symptoms prompted attention and early consultation around
(3) Genetic: The exact cause of intracranial tumors intracranial tumors is not clear on whether the genetic causes of psychiatric symptoms linked to brain tumors is still being explored because sometimes there may be similar in patients with schizophrenia or bipolar disorder symptoms therefore Quality problems in patients with premorbid attention Bleuler pointed out that these groups of non-organic nature of psychotic symptoms can be investigated from the family history of psychiatric problems found with the "intrinsic" spirit of the symptoms of brain tumors in families of schizophrenic patients or schizoid personality and bipolar disorder compared to those of the general population prevalence Davison (1986) Integrated 8 groups of patients a total of 3,000 cases of brain tumors in schizophrenia prevalence rate of 0% to 3.5% median and standard error of 1.2% Â± 0.2% higher than the general population prevalence of schizophrenia is clear from 0.2% to 0.5% of brain tumors and is associated with schizophrenia may be more likely to expect a large brain tumor Bleuler's views are not caused by schizophrenia or bipolar disorder itself The brain tumor but it can enhance the appearance rate of genetic predisposition; Davison that the brain tumor is likely to cause similar manifestations of schizophrenia
(4) tumor: a tumor infiltration of both sides of the hemisphere can trigger mental symptoms not necessarily caused by the side of hemispheric involvement in supratentorial and infratentorial tumors can be caused by mental illness like cancer because of the location and nature of such differ Keschner (19,371,938) reported 530 cases of 412 patients with brain tumors including 315 cases of psychiatric symptoms in 61 cases on the screen under the screen and mostly minor psychiatric symptoms in the advanced stage and they take Duanzan after supratentorial tumor that unusual for the auditory and visual hallucinations Duojian illusion about two Banqiu psychiatric symptoms occur when a tumor is causing the opportunities and lead to more attention to the form of some scholars (Kesehner other 1938; Gibbs 1938) reported that the left side of the tumor is causing more mental symptoms, but no statistically significant difference by Bingley (1958) pointed out that in the absence of the case of increased intracranial pressure intelligence and affective disorders especially prevalent in the left temporal lobe Houming De (1963), 82 cases of brain tumors in the 1 in the midline in the left occipital lobe 32.6% of those with mental symptoms and 34.2% of those on the right side there was no significant difference in behavior change
(5), increased intracranial pressure: Mental symptoms of increased intracranial pressure and the relationship between specific analysis can not be generalized to be caused by increased intracranial pressure than the optic disc edema, headache, vomiting and dizziness and confusion outside may have the spirit of apathy and even coma slow performance when the application decompression surgery or infusion of hypertonic glucose solution may be reduced or disappear when the Busch (1967) that mental retardation has nothing to do with increased intracranial pressure and mental retardation associated with, increased intracranial pressure caused by short addition to the corresponding other forms of mental symptoms behavior change has nothing to do with increased intracranial pressure
(6) psychological factors: In addition to the individual character and quality of external trauma patients with intracranial also evoked some of the factors that cause psychiatric symptoms 1 case of male right parietal meningiomas before surgery when the tumor was isolated from the review of hospitalization due to symptoms patients that a diagnosis was too late to delay surgery after surgery when the suspicious nurse dispensing phenytoin phenytoin say it was his turn for a drug suspected food poison suspected of containing his beloved mother came from a bad injury to his non-pregnant intentions to be jumped from the window is blocked can be virtually any organic mental disorder symptoms in the spirit of life events to reflect premorbid early in the disease so at least edit this paragraph | Back to top Symptoms
Variety of clinical manifestations of early and sometimes when symptoms are not typical are the basic characteristics of the tumor with a brain tumor when the incidence of advanced stage disease more often slow initial symptoms of increased intracranial pressure such as headache, vomiting and neurological symptoms such as decreased muscle strength, positioning and epilepsy weeks and months or years after the onset of symptoms were more acute exacerbations in a few hours or days can be a sudden deterioration in conditions coma and paralysis of this common tumor in the cystic tumor hemorrhage (aneurysm stroke) highly malignant tumor metastasis complicated by diffuse because of acute cerebral edema, or tumor (cyst) of cerebrospinal fluid circulation path suddenly blocked the rapid increase in intracranial pressure lead to brain herniation and death
1. General symptoms include physical symptoms and psychological symptoms
(1) physical symptoms: headache, nausea and vomiting, visual loss is optic disc edema and increased intracranial pressure caused by brain tumors 3 mainly because about 80% of brain tumor growth and expansion of the intracranial tumor patients had increased intracranial pressure
â‘ headache: the beginning of the morning and evening for the attack the day after the headache frequency increased more common part of many headaches in the frontal and temporal posterior fossa tumors and may be occipital headache after orbital radiation to the tumor where the short side of headache significantly with the progression of the disease can gradually increasing headache and sneezing was forced down persistent cough headache exacerbated when emotions lie down to reduce the time
â‘¡ vomiting: more than an empty stomach in the morning or when the vomiting occurs more commonly severe headache, most patients with nausea and lack of nausea and vomiting are not common emergency ejection in patients with severe vomiting and can not eat food after line of spit on the screen than infratentorial tumors occupying more than the damage occurred early and vomiting
â‘¢ optic disc edema: the next screen and optic disc edema and midline tumors appeared early and slow-growing tumor on the screen then appeared later and did not even occur mostly bilateral optic disc edema and visual impairment in early vision examination revealed no physiological blind spot continued expansion of the optic disc edema after a long time following the Fat pale optic atrophy optic disc gradually decreased visual acuity prompted the performance of the optic nerve atrophy has even blindness secondary
The other about 1 / 3 of patients with brain tumors occur frequently seizures increased intracranial pressure may also have seizures when the balance of adverse orthostatic distribution area of the trigeminal nerve tenderness dizziness, diplopia, abducens nerve palsy, etc. cataplexy in patients with acute or subacute cases can still have the pulse of blood pressure and respiration and pulse may be slow to 50 to 60 times per minute transfer between the breathing slow and become darker when the intracranial pressure continued to increase faster pulse and no law can be
(2) psychiatric symptoms: general psychotic symptoms of intracranial tumors, including confusion and dementia forgotten relatively rare syndrome, manic depression and schizophrenia-like psychosis
â‘ Confusion: Confusion is the general symptoms of brain tumors in different forms and can be expressed as the variability seen in any part of the fast-growing tumors are acute cerebral organic syndrome Bleuler (1951) reported that 37% of cases, but usually there is confusion not serious clinical problems seen slow to understand and slow reaction sluggish apathy inattention lethargy disorientation third ventricle colloid cyst occurring as intermittent hydrocephalus can be a fluctuating disturbance of consciousness and sometimes patients may suddenly return to normal sometimes the state will soon turn into delirium when the intracranial pressure was significantly higher state of consciousness can occur rapidly deteriorating This is due to hernia of the hook back to the confusion it is not entirely caused by the increased intracranial pressure due to loss of brain stem and brain tumors, and network inter- like structure can also occur when the confusion or coma attack
â‘¡ forgotten syndrome: Bleuler (1951) share the information forgotten syndrome, brain tumor, 38% of cases of diffuse brain damage is the result of the slow growth of this syndrome is common in cases of intracranial tumors (Gelder 1983, etc.), but close to the bottom of the third ventricle of the brain and can also cause damage to the limitations of increased intracranial pressure when the time value of forgotten syndrome without positioning the absence of increased intracranial pressure has prompted the Ministry of cancer patients early in the skull base can be decreased recent memory performance or forgotten past experience Memory can not replicate or even new memory occurs immediate memory can be distorted but the general development of the disease is relatively good, there may be disorientation, anterograde amnesia, and accompanied by the phenomenon of Xhosa fiction Markov Syndrome often indifferent to the shortcomings of memory
â‘¢ dementia: Slow grow and stage of disease longer can be expressed in brain tumor patients showed dementia and the sense of the defects calculated Lijie this symptom in the early work was unable to cope with the timely detection and rapid growth of polymorphous infiltration of glial Cheng cell tumor may occur shortly after the onset of mental decline Sachs (1950) pointed out that meningiomas can cause dementia, especially for older patients with brain tumors rapidly developing dementia of any particular state of the patient's body should be suspected disproportionate brain tumor middle-aged and elderly patients there is increased intracranial pressure syndrome can be forgotten in the early stage of advanced dementia, there may be the outcome of thinking often slow thinking, poor empty the contents of inconsistent statements can not understand the strange behavior disorders and mental retardation
â‘¤ affective disorder: brain tumors associated with affective disorders more common in the general apathy less depression and more indifferent to external things to look sluggish on lack of initiative; also be seen laughing and crying without cause mood swings irritability, anxiety, depression, irritability, crying easily; in particular, temporal lobe tumor with intracranial tumors are rare manic hair companion made the performance of naive patients with frontal lobe tumors occasionally euphoric symptoms
â‘¥ based on the occurrence of heart because of psychotic reaction: whether it is the attitude of intracranial tumors in patients with psychotic reactions occur after surgery or transient psychotic reactions are the basis of existing cardiac disease before the patient is also related to the personality behavior of organic non-specific defects found in the compensation brain injury and other brain organic diseases see the head injury associated with mental disorders section
â‘¦ patients with personality changes and behavioral performance decrease lack of initiative and interest in life, lack of lazy behavior of a passive sense of shame I do not know do not take the initiative to clean and eat all day sitting or even similar to the bedridden silent stupor; some running around or shouting or collection of filth abnormal behavior and personality changes often simultaneously intelligent change
2. Limitations of diagnosis of symptoms related to cancer and nervous system must pay attention to the positioning of the symptoms can be combined to make the right to judge the appearance of psychotic symptoms due to tumor involvement of the different parts of the performance of the positioning of different symptoms in different parts of the brain features can have their neural anatomy of the area to determine the structure and physiological function
(1) frontal lobe: the frontal lobe in the front of the central sulcus and the lateral fissure on the back and bottom of the frontal cerebral artery from the inner side of the frontal lobe tumors from the anterior cerebral artery can be barriers to the performance of three language and voluntary movement mental activities
â‘ voluntary movements: the frontal lobe contralateral efferent impulses reach the cerebellum via the pons on the free movement of Freemasonry adjust the lateral frontal lobe tumors can cause back of the contralateral limb ataxia without nystagmus central gyrus that movement occurred when the tumor Exercise can cause focal seizures without loss of consciousness or finger hemifacial clonic convulsions occurred
â‘¡ language: the left inferior frontal lesions of the island covered in motion or expressive aphasia
â‘¢ mental activity: expression of indifference mainly dull the spirit of understanding and sense memory, decreased attention and comprehensive thinking, reduced ability to pay attention to clean toilet and sometimes I wonder if there is strong grip and explore the reflection may have damaged the main hemisphere aphasia
A. Personality changes: the behavior of frontal lobe tumor patients become euphoric feeling awkward childish indulgence and the idiocy of the performance of lewd humor in patients with frontal lobe tumors to the contrary feelings and will exist for the characteristics of activities, such as euphoria and apathy co-exist jokes and the indifference of the surrounding bowel and self-control with the irresponsible lack of change in the future will also common
B. no desire - Sports can not - will of the deficiency syndrome (apathetic-akinetic-abulic syndrome): prefrontal lesions can occur on both sides of this syndrome, especially patients with impaired performance of apathy do not pay attention to the lack of interest around the instrument clean slow decline careless lack of imagination and initiative thinking ability and memory and slow mental deterioration of wood to stay confused facial expression
C. stupor: the rapid growth of frontal lobe tumor expression was observed in patients with stupor of inactivity in silence for a long time not eat there urine control can even be an obstacle
The frontal lobe is not a specific clinical syndrome as seen in temporal lobe tumors in the temporal lobe damage caused by the hook back to the attack can be found in the frontal lobe tumor
(2) of the corpus callosum: surgical removal of the corpus callosum does not produce any symptoms of the corpus callosum tumors cause severe psychiatric symptoms than other parts of the more common mainly due to losses and the adjacent frontal lobe and between the brain, the brain between the corpus callosum Tsui tumor of 92% of mental symptoms of middle 57% pressing the Department for 89% (Schlesinger 1950) Selescki (1964) also considered that after the former Ministry of common tumor of the corpus callosum did not appear in the neurological signs before the headache and increased intracranial pressure already obvious mental decline (Lishman1978 ) Clinical, there may be affective disorder and intellectual defects of the corpus callosum anterior and middle 1 / 3 the tumor may have speech disorders such as speech-poor imitation of speech and of verbal comprehension defects of the corpus callosum posterior damage were often appear and memory and disorientation of the things around Recognition is also difficult because the tumor was easily damage occurred near the third ventricle of the brain tissue, such as between the cingulate and other brain and thereby enrich the spirit of the symptoms associated with corpus callosum tumors personality disorder similar to those caused by tumors involving the frontal brain area can be seen between sleepiness sleeping and motor abnormalities can not be a strange attitude similar exercise stress disorder
(3) the temporal lobe: Temporal lobe tumor is glaring when the psychiatric symptoms of increased intracranial pressure more than a feeling of visual field defect, mental automatism epileptic aphasia illusion of deep lesions, there may be contralateral to the hemianopia with or 1 / 4 of visual field defects in primary hemisphere lesions Because there may be sensory aphasia with temporal lobe and frontal lobe adjacent to the fiber links it closely, there may be some of the frontal lobe where the tumor symptoms such as personality changes, no desire - Sports can not - will be limited to the lack of temporal lobe syndrome, stupor and so the tumor can be There are two forms of mental disorders, including intermittent hook back episodes of seizures and behavior and mood changes
â‘ hook back to the attack: Magic attack often begin suddenly taste and smell Magic olfactory odor or smell or taste may be associated with mild dizziness followed by some confusion and a dream-like state was called the hook back to the time patients do not attack realistic, such as deja vu or something as new as the old thing was big or small around the sound was particularly loud that the perception of space and time have changed the time that distant objects appear near the film kind of flies fast lens that is too long may have experienced abdominal flash discomfort is also associated with fear of the uplink for the original visions of a dream to see the light but complex hallucinations associated with auditory hallucinations rare common illusion is often interwoven with other forms of complex formation with the kind of experience the onset of sleep talking mouth automatic action can be seen licking lips taste like chewing movement
â‘¡ automatism: automatic multi-disease is also common symptoms in the evening in the form of an automatic temporary post for one more forgotten variety of patients can only simple movements such as walking in the room is not the purpose of sorting clothes and sometimes things move a more complex behavior can occur such as roaming out automatically each time as a specific disease onset in patients with the same
â‘¢ intermittent episodes of behavior and mood changes: temporal lobe tumor did not change when the character similar to frontal lobe tumor-specific, such as when the aforementioned Strobos (1953) found that 11% of patients with temporal lobe tumors and paranoid personality disorders tend to focus on their own Health and irritability temporal lobe tumors outstanding personality of the original or a premorbid personality of the tumor or the response form of epilepsy
The performance of emotional instability and irritability often full of aggressive emotion outbreaks and acts of violence are some of the temporal lobe tumors, such as performance anxiety, depression, dysphoria and depression need to distinguish
Interictal schizophrenia-like psychosis there were not uncommon in most of these mental disorders seen in temporal lobe tumor was followed also found in pituitary tumor (Lishman1978) some of these cases the tumor may cause or induce the onset of symptoms with schizophrenia, the genetic quality of the others might caused directly by temporal lobe lesions
(4) parietal lobe: lobe tumors cause psychiatric symptoms than the frontal or temporal lobe tumor less easily lead to cognitive dysfunction sensory dysfunction often occurs mainly sensory epilepsy sensory trunk contralateral limb (including the cortex sense), episodes of decreased sensation abnormal loss of use of such lesions may be beneath the main hemisphere miscalculations and self-reading agraphia agnosia disorders such as body parts of parietal lobe lesions cause motor and sensory aspects of the earlier signs of lower lobe tumors misdiagnosed as mental illness can occur when the integrated sensory dysfunction Advanced Many patients with complex cognitive activities can cause obstacles to bilateral parietal lesions determine the difficulty and terrain visual-spatial disorientation
The formation of the body like the parietal cortex, passing information through proprioception comprehensive results are therefore a variety of parietal lobe tumors may present with loss of body image disturbance, such as awareness or neglect of one side (unilateral unawareness or neglect) hemi-body identification (hemisomatognosis) adverse disease agnosia (anosognosis) from the body parts agnosia (autotopagnosia) duplication (reduplication phenomenon) can not form comprehensive (amorphosynthesis) and other patients not impaired sense of touch and pain but can not identify objects by touch sensory disturbance that entity (astereognosis ) can not say a word or graphics program palm what is commonly known as writing a sense of loss when the tumor spread to the occipital lobe visible when the rear looks agnosia
Parietal lobe performance of cancer patients may have depressive personality disorder is rarely seen in these patients on self and surroundings (such as clothing) and so are not properly pay attention to patients, there may be hesitation and difficulty dressing apraxia as dressing (dressing apraxia ) sometimes leads to misdiagnosed as dementia or hysteria
(5) the occipital lobe: The occipital lobe is relatively rare cancer caused by psychiatric symptoms mainly visual barriers to visions most common cause of visual field defects in addition to no clear limitations outside the clinical symptoms of primary produce hemianopia contralateral to the hemisphere with the lesion can be visual agnosia did not know that that is the color of objects and posterior parietal lobe and temporal lobe contralateral lesions appear only 1 / 4 or 1 / 4 of visual field defects such as pungent as the occipital lobe lesions seen visions of Original occipital lobe tumor involving the parietal and temporal lobes, as the magic when the image of the complex where the tumor earlier because of increased intracranial pressure caused by psychiatric symptoms can have a corresponding
(6) between the brain: The tumor can damage the hypothalamus and adjacent hypothalamic third ventricle can be expressed metabolism dysfunction of the autonomic nervous endocrine disorder neuropsychiatric disorders showed significantly more psychiatric symptoms such as memory impairment obvious personality changes recession in the major intelligence are: irritability allergic irresponsible reckless impulse excited to work others do not care about childish behavior and personal habits, etc.
â‘ memory impairment: a tumor involving the third ventricle, 14% had memory deficit (Williams and Pennybacker1954) showed some cracks - between fictional syndrome violations craniopharyngioma brain and third ventricle increased intracranial pressure, such as exclusion factors of memory impairment can also be found in special
â‘¡ dementia: the cerebrospinal fluid circulation can cause chronic obstructive cortical atrophy of brain tumors among so the performance may have dementia, especially in middle-aged and elderly patients prone to
â‘¢ personality changes: brain tumor can be seen between the frontal lobe syndrome similar to personality changes such as decreased initiative and other acts of childish humor, but with differences between frontal lobe damage in patients with brain lesions are not impaired insight
â‘£ paroxysmal or periodic mental disorders: part of lesions between the brain can cause behavioral changes in patients with paroxysmal or recurrent mood swings of mood and sometimes large and sometimes depression or emotional control to reduce the frequently caused anger among brain tumors confined to non-visible the purpose of excitement and stagnation phase alternating psychosis trance each phase lasting 1 to 2 weeks in patients with third ventricle colloid cyst may have a sudden headache start and sudden stop episodes of delirium or confusion
â‘¤ sleepiness - bulimia: a common cause of brain tumors between somnolence and sleep over but can wake up a diagnosis of some value to increase appetite
(7) Under the Canopy of the tumor: the spirit of infratentorial tumors less symptoms and more advanced stage of such disease, including the cerebellum and medulla oblongata cerebellopontine angle tumor pontine which the cerebellum and posterior fossa tumors of the cerebellopontine tumor clinical sites in myeloid Wilms tumor and nerve sheath tumors referred to in the lower pons and medulla oblongata in the brain stem of biological growth if there are new episodes of silence may appear slow thinking, mood swings and memory deficit and confusion to loss of consciousness, increased intracranial pressure has nothing to do with the onset of sustained short-term only 3 ~ 10min associated with blood pressure, heart rate respiratory changes in skin color, limb muscle tension in the posterior fossa tumor patients before and after surgery are prone to short-term disorder mainly for the time conscious as depression or paranoid psychosis
(8) Central Area: You can boost the performance of the limitations of the contralateral limb symptoms also may develop seizure generalized seizure
(9) pituitary: the performance of sleepiness and more limitations of urinary function in obese amnesia and personality change uncus of temporal lobe epilepsy seizures and other mental retardation apathy indifference to their own health behavior of the passive mood swings irritability or sudden anger is also common or there paranoid state
Must comply with the CCMD-2-R in the brain organic mental disorder diagnostic criteria and on the evidence of intracranial tumor and the occurrence and course of mental disorders associated with brain tumor brain tumor associated with psychiatric symptoms are not typical behavioral changes Location signs and symptoms of the lack of difficulty are first diagnosed with history and physical examination to make early diagnosis of brain tumors
The importance of early diagnosis of brain tumors should first be clear: whether with or without brain tumors and other intracranial diseases require identification; the site of tumor growth and the relationship with the surrounding structures for accurate positioning of craniotomy is very important; tumor properties, such as pathological diagnosis can be done in determining the treatment and prognosis Jieyou reference to history and clinical examination is the basis of correct diagnosis of brain tumors after onset of initial symptoms and the order of onset of symptoms is important for diagnosis of headache and nausea and vomiting optic disc edema is a common somatic symptoms three psychiatrists for all patients with mental disorders should be carefully conducted physical examination and neurological examination of headache patients with chronic headache patients can not be taken lightly nature of change or new headache with no known cause of paroxysmal headache started after the should pay particular attention to the continuing exclusion of intracranial tumors, brain tumors may show some short-term or special dysfunction occurs when the parietal lobe the tumor confusing area of cognitive impairment or next to the sagittal side of lower limb weakness occurs when the tumor is easy to be confused with hysteria attention
Some parts of the tumor can cause sluggish, and the like silence to less stress disorder misdiagnosed as tension-type performance at home and abroad about the misdiagnosis of schizophrenia reported misdiagnosed as schizophrenia, depression and hysteria for a maximum performance of many brain tumor patients with depressive symptoms low-fat mania
To the families of patients with abnormal behavior to the development of the disease and if the situation continued progress in the clinical course has nothing to do but should consider the possibility of brain tumor symptoms of brain without the limitations of any specific brain disease spread to these areas can cause if it is to be assisted with medical history and Check Edit this paragraph to be considered full | Back to top Treatment
Early detection and early treatment of all diseases is the principle of treatment of intracranial tumors sooner the better the treatment is no exception treatment, including surgery chemotherapy radiotherapy immunotherapy Chinese medicine and other psychiatric symptoms should be chosen for the side effects of high prices and small dose of antipsychotic medication should not be too large, especially in postoperative chemotherapy and radiotherapy in patients with epilepsy associated with plasma concentrations should be monitored
Term evaluation of disease: participation in evaluating the authority of a total of 0 0% 0% rich professional good 0% 0% 0% I have to evaluate the poor:
Xiao *** a shadow to the occipital lobe or brain tumors were diagnosed as encephalitis do
1 #, and his exchange
Encephalitis, or brain tumor
Disease description (main symptom onset): the heart, nausea, dizziness, neck discomfort, in May 2008 after a motorcycle fell tumble symptoms.
And effectiveness of treatment was: eat a number of cervical drugs, the effect is not ideal.
Want kind of help: how to diagnose my illness? Now I should do? Pay attention to what?
Testing, test results: a recent film to have such a description of the hospital: the right occipital lobe shows patchy abnormal signal intensity, T2WI and FLAIR high signal, T1WI was so low signal, the edge is unclear, the size on 1.7 * 1.5cm , enhanced scan showed mild enhancement of small dot-like. Both sides of the ethmoid sinus mucosal thickening. (Ellipsis sections describe is normal), Conclusion: Encephalitis and differentiated astrocytomas
Visiting the hospital the last time: Wuzhou Red Cross Hospital
Posted at 2009-11-30 18:18:31 Dr Zhang Re: the shadow to the occipital lobe or brain tumors were diagnosed as encephalitis do
2 # Guangzhou Brain Hospital, Professor, MD, chief of neurosurgery plus
Can be identified, in a minor operation under stereotactic, take out a small piece of brain tissue for pathological examination, which can be confirmed.
Brain surgery Brain Hospital, Guangzhou Tel :020 -81574878 Zhang (brain surgery), http://zhangliangdf.haodf.com
Guangzhou Brain Hospital of Neurosurgery, Chang Liang
Zhang Posted at 2009-12-04 07:46:07 my doctor Xiao *** 3 #, and his exchange
Thank you very much Xiazhu Ren!
I have another question: I was in Wuzhou City, the two largest hospital, the doctor gave two different proposals, a hospital advised me to hospital as soon as possible, while the treatment side of the observation, one month after diagnosis; another hospital said condition is not obvious now that there is no need hospitalization, one month after the referral directly to film, we can compare before and after the film confirmed that time and then determine the treatment. Xiazhu Ren, you should understand a patient's psychological, I'm very worried, I do not know how to do that!
I would also like to go directly to your hospital, they do not know how long need to leave, Xiazhu Ren, you can give me a suggestion?
Posted at 2009-12-04 14:12:50 Dr. Zhang 4 # Guangzhou Brain Hospital, Professor, MD, chief of neurosurgery plus
This general practice is to observe, over time, review the MRI, should not review the CT, MRI better. If the patient is very nervous, we advised him to hospital, take a little under stereotactic brain tissue diagnosis. Overall, a very small lesions, not too nervous.
Brain surgery Brain Hospital, Guangzhou Tel :020 -81574878 Zhang (brain surgery), http://zhangliangdf.haodf.com
Guangzhou Brain Hospital of Neurosurgery, Chang Liang
Dr. Zhang published in 2009-12-04 15:17:45 I *** 5 # Shaw and his exchange
Thanks again Xiazhu Ren, Wuzhou City, a few days ago I went to the hospital to consult a moment, the doctor or should I say my symptoms are not obvious, you also need to review some time later, a doctor mentioned the pathological analysis of bone marrow I do not know the pathological analysis of bone marrow and the next you say take out a small piece of stereotactic brain biopsy are the same. I want to know if I want to go to your hospital to do a stereotactic you remove a small piece of brain tissue under the minor surgery, can easily make to it? How long? What is the approximate cost?
Xia Zhuren hope you reply!
Posted at 2009-12-15 21:49:42 Dr. Zhang Guangzhou Brain Hospital # 6 Chief Physician, Professor of Neurosurgery, plus
I Zhang. Bone marrow examination is not necessary to do, is to stereotactic brain. Proposed temporary observation, consider biopsy if the lesion grew up. Guangzhou Brain Hospital of Neurosurgery, Chang Liang
Dr. Zhang Xiao my *** Posted 7 # 2009-12-16 11:22:59 communicate with him
Is Professor Xie Xiezhang!
Posted at 2009-12-19 17:42:07 Dr. Zhang 8 # Guangzhou Brain Hospital, Professor, MD, chief of neurosurgery plus
Good. Guangzhou Brain Hospital of Neurosurgery, Chang Liang
Dr. Zhang published in 2009-12-21 07:46:25 I *** 9 # Xiao communicate with him
Hello, Officer. Today I went to review the Wuzhou Red Cross Hospital MRI, results like last time, the lesions did not grow up, have not disappeared, just call to review after a period of time, but can first eliminate anti-inflammatory, I would like to ask, given that Stereotactic a minor operation can be confirmed under, and why doctors do not recommend me to do it? Not diagnosed before the anti-inflammatory useful? Look forward to reply!
Posted at 2009-12-30 18:59:55 Dr. Zhang 10 # Guangzhou Brain Hospital, Professor, MD, chief of neurosurgery plus
If you do not trust to come back to. A few days ago we did a small lesion, diagnosis of hemangioma. The surgery is not possible lesions deep to measure the pros and cons. I watched the film will be better. Guangzhou Brain Hospital of Neurosurgery, Chang Liang
Dr. Zhang Xiao my *** Posted 2009-12-31 08:59:15 and his communication of 11 #
Thank you Director Zhang! I really think you look at your hospital director to find, just do not know under stereotactic surgery in brain how complex this is not the surgery done, there is treatment to surgery from diagnosis, usually how many days? Because the distant road, work also need to leave.
Posted at 2009-12-31 16:25:55 Dr. Zhang 12 # Guangzhou Brain Hospital, Professor, MD, chief of neurosurgery plus
Stereotactic biopsy, hospital about a week to 10 days. Guangzhou Brain Hospital of Neurosurgery, Chang Liang
Zhang Posted at 2010-01-04 08:47:00 my doctor
Variety of clinical manifestations of early and sometimes symptoms are not typical, and when the tumors already have the basic features, the condition is often already in the late onset of many brain tumor is slow, initial symptoms of increased intracranial pressure such as headache, vomiting and symptoms of nerve localization such as weakness, epilepsy, weeks, months or years later, the symptoms increase exacerbations, acute disease may in a few hours or several days, a sudden deterioration in condition, paralysis, coma, the more common cystic tumor , tumor hemorrhage (aneurysm stroke), highly malignant tumors, tumor metastasis, complicated by diffuse cerebral edema, or because of the tumor (cyst) of cerebrospinal fluid circulation path suddenly blocked the rapid increase in intracranial pressure, leading to brain herniation and death.
1. General symptoms include physical symptoms and psychological symptoms.
(1) physical symptoms: headache, nausea and vomiting, optic disc edema and vision loss is caused by brain tumor, increased intracranial pressure 3 mainly due to brain tumor growth and expansion of about 80% of patients had intracranial tumors increased intracranial pressure.
â‘ headache: episodic start to the morning, more common at night, the day after the headache, the number of headache in the forehead and part of multi-temporal, posterior fossa tumors can post-occipital headache, and radiation to the orbital, in short, headache where Ce significantly to the tumor, with disease development, and headache can be gradually increased and remained persistent coughing, exertion, sneezing, bow, agitation increased when the headache, lie down to reduce the time.
â‘¡ vomiting: more than occurred in the early morning or fasting, severe headache and vomiting are more common when the patients are mostly accompanied by nausea, lack of nausea and vomiting sudden injection is not common in patients with severe vomiting and can not eat, food, spit it out after the line, screen than the screen on the tumor occupying more than the damage occurs early and vomiting.
â‘¢ optic disc edema: screen appears under the optic disc edema and midline tumors early, while the screen is slow-growing tumor appeared later, not even occur mostly bilateral optic disc edema, early non-visually impaired, visual field examination showed expansion of the physiological blind spot, optic disc continued After prolonged edema, may be secondary to optic nerve atrophy, optic disc gradually pale, vision loss, suggesting that the performance of the optic nerve atrophy has been secondary, or even blindness.
The other about 1 / 3 of patients with brain tumors occur frequently seizures, increased intracranial pressure may also have convulsions, poor balance when standing position, the trigeminal nerve distribution area tenderness, abducens nerve paralysis, diplopia, dizziness, damping-off and so on, in the acute or subacute cases, can still have pulse, blood pressure and respiration and pulse may be slow to 50 to 60 times per minute between, breathing slow and become darker turn, sustained increases in intracranial pressure, the pulse can be faster and not law.
(2) psychiatric symptoms: general psychotic symptoms of intracranial tumors, including confusion, forgotten syndrome, dementia, and relatively rare kind of manic-depressive and schizophrenia-like psychosis.
â‘ Confusion: Confusion is the general symptoms of brain tumors, can be expressed as different forms and variability, can be found in any part of the fast-growing tumors, are acute organic brain syndrome, Bleuler (1951) reported that 37% of cases intentionally vague, but usually not serious, clinical responses seen to understand He difficult, slow, unresponsive, sluggish, lethargy, inability to concentrate, apathy, disorientation, third ventricle colloid cyst occurs, due to intermittent hydrocephalus, can be a fluctuating consciousness, and sometimes the patient may suddenly return to normal, sometimes very quickly into delirium status, intracranial pressure was significantly increased, can be rapidly deteriorating state of consciousness, which is due to a hook back to the hernia, therefore, to confusion is not entirely caused by the increased intracranial pressure, because the brain stem and brain tumor damage, and between the network structure, they can attack occurred confusion or coma.
â‘¡ forgotten syndrome: Bleuler (1951) of the information, forgotten syndrome, brain tumor, accounting for 38% of cases, diffuse brain damage is the result of the slow growth of this syndrome is common in cases of intracranial tumors (Gelder, etc. 1983), but near the bottom and the third ventricle of the brain damage can be caused by limitations, when the intracranial pressure increased, the forgotten syndrome without positioning value, without increased intracranial pressure, it has prompted the Ministry of skull base tumors, patients in the early stage decreased recent memory performance or forgotten, the memory of past experiences can not be reproduced, and even new memory distortion occurred, but generally immediate memory can be relatively good, there may be progression of the disease disorientation, anterograde amnesia, and phenomena associated with fictional Ke Sa Markov syndrome, patients often indifferent to the shortcomings of memory.
â‘¢ dementia: slow growth and relatively long disease of brain tumor patients may manifest dementia, performance computing, understanding and sense of defect, the symptoms may be unable to cope with the early work to be identified, and rapid growth of polymorphonuclear infiltration of glioblastoma may occur shortly after the onset of mental decline, Sachs (1950) pointed out that meningiomas can cause dementia, particularly in elderly patients with brain tumors, for any rapid development of dementia, particularly in the state with the patient's body disproportionate, should doubt the existence of brain tumor, middle-aged and elderly patients increased intracranial pressure syndrome can be forgotten in the early stage, late stage dementia often the outcome, there may be slow thinking, poor thought content, empty, incoherent statements, behavior disorder and the strange, incomprehensible, and mental retardation.
Case: Male, 19 years old, unmarried, workers, usually outstanding work, the unit is to be mentioned its cadres, but the examination when the self-inductance of a disgrace to the leadership has done nothing, after the illness lethargy, decreased work efficiency, in a daze, the first 3 days that is not in bed , the living who need food, eyes closed all day, poor orientation, memory loss, and soon developed to the toilet can not take care of themselves, the situation is getting worse, in hospital 12 days after the death, the autopsy found that the left temporal lobe is a huge dermoid cysts, tumors from the inside of the left part of the brain side room, full of the entire left side room, the left brain volume expansion, the cause of death on both sides of the hippocampus, Department of hernia formation.
â‘£ schizophrenia-like psychosis: Although intracranial tumors can cause schizophrenia, but they exceeded expectations associated with the possible opportunities that may exist in particular parts of the brain tumor can cause schizophrenia-like psychosis, schizophrenia such cases, clinical and disease is similar, but the course is short, the content is not absurd delusions, hallucinations in the auditory hallucinations in more, may also have visual hallucinations, olfactory illusions and magic touch, and sometimes can be seen and perceived hypersensitivity or disappear comprehensive barriers, perceived barriers often associated with abnormal behavior simultaneously.
Case: Male, 38 years old, married, workers, 2 years ago headache in the forehead and left temporal, showing tic-like pain, improved after the break, after 1 year and night ventilation nausea and vomiting, headache gradually aggravated, unresponsive , apathy, mental sluggishness and calculation slow, shallow trench left side of the nose, Shenshe left side, ultrasound examination revealed midline deviation, surgery proved to frontal meningioma and the patient appears suspicious, the surgeon with suspected abnormal relationship between lovers, doctor, unit comrades and loved his collusion with vital that the toxic meal feeding, the doctor injected him with a lot of inexplicable injection to touch him, to the service of chlorpromazine, perphenazine and other drugs is invalid on the 8th day after suicide attempt, causing the head incision dehiscence and rupture, out of danger after emergency treatment by surgical reversal of improvement in psychiatric symptoms still can not see that the surgeon should marry his lover, the impulse from time to time, as the management transferred to psychiatric difficulties, but soon delusion, self wronged people, apologize to the surgeons.
â‘¤ affective disorder: brain tumors associated with less affective disorders, generally more common apathy, depression, mostly indifferent to external things, looked sluggish, lack of initiative; also see no reason laughing and crying, mood swings, irritability, , depression, crying easily, irritability, anxiety; especially the temporal lobe tumor, brain tumor and the company of hair are rare manic hair, the performance of naive patients with frontal lobe tumors, occasionally euphoric symptoms.
Case: Male, 52 years old, married, cadres, and 10 years of repeated episodes of psychosis and hospitalization, in 1980, insomnia, dizziness, depression, rest at home, because of past (1976) diagnosis of gastric surgery gastric cancer in situ, this when they worry about whether suffering from brain cancer, ruled out by brain CT examination in 1981, his wife and daughter to pay her boyfriend to go out to play cards dissatisfaction, performance irritability, also once suspected his wife and daughter for their malicious, out-patient drug treatment after remission, recurrence in 1983, withdrawal, performance with the former, after treatment improved in March 1985 had a slight attack, if the performance of more irritable, soon after taking control in 1986, the right facial twitching paroxysmal right ear hearing loss, discontinued in 1988 because of disease, so much excitement, extravagance, stopping everywhere, visiting teachers and students have been linked for years, as over 50 invited guests great birthday, self smart, strong, regular review of head CT, found the right side of the cerebellopontine angle region with a cross in the posterior fossa of the low-density lesions to the possibility of a large intracranial epidermoid tumors by medication and psychiatric symptoms under control, the two years 1988 and 1989, fluctuations in mild condition, But most of the time normally, in 1991 and made, the performance of insomnia, excitement, so much, she bought food, inquisitive, and constantly and friends, love comments, boast of their talents, CT review the film can still see the original lesion, the morphology , location, size, density did not change significantly, the cases with affective disorders are associated with intracranial tumors, the former may induce recurrence of the latter effect.
â‘¥ on the basis of heart occurred because of psychotic reaction: whether it is the attitude of intracranial tumors in patients with psychotic reaction occurs, or after surgery a transient psychotic reactions are present psychogenic basis, and patients have premorbid personality related to the compensation of the organic acts of non-specific defects found in brain damage and other brain organic diseases, see traumatic brain injury associated with mental disorders section.
â‘¦ personality changes and behavioral performance of patients with abnormal lack of initiative, interest reduction, life lazy, passive behavior, I wonder if clean, the lack of shame, not actively eating, sitting, or bed-ridden all day long, silent, or even similar to the stupor; have or cry, run around, or collection of filth, personality changes, abnormal behavior and intelligence to change often occur simultaneously.
2. Limitations of diagnosis of cancer symptoms, you must pay attention to the positioning of the symptoms and the nervous system combined for analysis in order to make the right judgments, the emergence of psychotic symptoms, due to tumor involvement of the different performance of different parts, each part localization of brain tumors with the characteristics of the various symptoms, according to the anatomical location and physiological function of nerve to judge.
(1) frontal lobe: the frontal lobe is located before the central sulcus, lateral fissure on the frontal lobe and the outer surface of the bottom back middle cerebral artery from the inner side of the anterior cerebral artery from the frontal lobe tumor can be obstacles to the performance of three aspects, namely, voluntary movement, language and spiritual activities.
â‘ voluntary movements: the frontal lobe contralateral efferent impulses reach the cerebellum through the pons on the free movement of Freemasonry regulation, frontal lobe tumors can cause the back outer side of the contralateral limb ataxia, but no nystagmus, which sports the central gyrus occurred when the tumor can cause exercise-induced focal epilepsy, seizures loss of consciousness, facial or finger clonic convulsions occurred.
â‘¡ language: the left inferior frontal lesions of the island covered in motion or expressive aphasia.
â‘¢ mental activity: the spirit of mainly lackluster, indifferent expression, memory, attention, understanding and sense of loss, decline in thinking and comprehensive ability, pay attention to cleanliness, I do not know urine, sometimes strong grip and explore reflection by the main side of the hemisphere loss can have aphasia.
A. Personality changes: the behavior of patients with frontal lobe tumors become indulgent and stupid, euphoric mood, childish, foolish nature of the performance of obscene humor, frontal lobe tumors in the opposite feelings and will exist for the characteristics of activities, such as euphoria and apathy co-exist and loves to joke around with the same indifference in, irresponsibility, irritability, and lack self-control system is also common to change.
B. no desire - Sports can not - will of the deficiency syndrome (apathetic-akinetic-abulic syndrome): prefrontal lesions can occur in this syndrome, especially bilateral lesions, patients showed apathy, lack of interest on the surrounding, pay no attention to meter clean, slow, careless, imagination and thinking ability decline, lack of motivation, memory and mental deterioration, slow, confused facial expressions, stay wood.
C. stupor: the rapid growth of frontal lobe tumor expression was observed stupor, the patient in a long time of inactivity, silence did not eat, and even there may be barriers to control urination.
The frontal lobe syndrome is not specific, as seen in clinical cases of temporal lobe tumor, and temporal lobe damage caused by the hook back to the attack also found in frontal tumors.
(2) of the corpus callosum: surgical removal of the corpus callosum does not produce any symptoms, and the corpus callosum tumors cause severe psychiatric symptoms than other parts of the more common, mainly due to losses and the adjacent frontal and diencephalic, midbrain relationship, the corpus callosum Tsui Department of tumors 92% of psychiatric symptoms, middle 57% pressing the Department for 89% (Schlesinger, 1950), Selescki (1964) also considered that the front and rear common, anterior corpus callosum tumors in the absence of neurological signs, headache and intracranial hypertension before the already obvious mental decline (Lishman, 1978), clinically, there may be affective disorder and intellectual defects of the corpus callosum anterior and middle 1 / 3 tumors, may have language barriers, such as verbal poor imitation of speech, as well as speech understanding of the defects, damage to the rear of the corpus callosum, the memory and disorientation, often appear on the identification of things have taken place around the difficulties, the tumor easily damage adjacent brain tissue, such as the third ventricle between the brain and the cingulate bundle, etc. therefore be accompanied by a more extensive psychiatric symptoms, the corpus callosum tumors personality disorder similar to those caused by frontal lobe tumors, involving the brain between the visible parts of drowsiness, lethargy and exercise can not, like a strange catatonic posture abnormal movement.
(3) the temporal lobe: psychiatric symptoms in temporal lobe tumors is striking, and many have increased intracranial pressure, visual field defects, sensory aphasia, epilepsy, mental automatism, hallucinations, deep lesions, there may be contralateral to the hemianopia with or 1 / 4 visual field defect, the main hemisphere lesions can occur sensory aphasia, the temporal lobe and frontal lobe near the close of the fiber links and, therefore, there may be some of the frontal lobe where the tumor symptoms such as personality change, no desire - Sports can not - will the lack of syndrome, stupor, etc., limited to the temporal lobe tumors may have two forms of mental disorder, including the hook back to the attacks and intermittent episodes of behavior and mood changes.
â‘ hook back to the attack: attack tend to taste and Magic Oh Magic began, suddenly smelled the odor or smell or taste, some may be associated with mild dizziness, confusion, and was followed by a dream-like state known as the hook back to attack, its When patients are not realistic, such as the familiar, or old things as new, depending on the material were large or were small, around the voice of that particular loud, space and time perception has changed, that near objects far away, time seems to film fast lens like the flies, experienced over a long flash that may have abdominal discomfort uplink, also associated with fear, visions for the original, see the light, but complex hallucinations associated with common dreams, auditory hallucinations rare, often associated with other woven in the form of hallucinations of balderdash to form a composite sample with experience, can see the mouth attack automatic action, such as chewing, licking lips, taste movement.
â‘¡ automatism: automatic disease is also common, and more appear in the evening, automatism in various forms, for one more short-lived, and afterwards forgotten, the patient may only simple movements, such as the aimless walk in the room, sorting clothing, move things, and sometimes more complex behavior can occur, such as roaming out, as a specific patient, every auto attack is the same disease.
â‘¢ intermittent episodes of behavior and mood changes: temporal lobe personality changes when the tumor is not specific, similar to the frontal lobe tumors, such as when the aforementioned, Strobos (1953) found that 11% of patients with temporal lobe tumors and paranoid personality disorders tend to , concerned about their health and irritability, temporal lobe tumors prominent personality of the original, or premorbid personality of the tumor or the response form of epilepsy.
The performance of emotional instability, irritability, and attractive and often emotional outbreaks and acts of violence, some patients with temporal lobe tumors anxiety, depression and dysphoria, such as performance, need and depression differences.
Interictal schizophrenia-like psychosis there were not uncommon, most of these mental disorders seen in temporal lobe tumor, followed also found in pituitary tumor (Lishman, 1978), some of these cases the tumor may cause or induce a schizophrenia genetic predisposition the onset of symptoms, others may be directly caused by the temporal lobe.
(4) parietal lobe: lobe tumors cause psychiatric symptoms than the frontal or temporal lobe tumor less easily lead to cognitive impairment, mainly sensory dysfunction, sensory epilepsy often occur, the contralateral limb, trunk sensation (including cortical vision ) loss, episodic paresthesia, loss of use, etc., beneath the main hemisphere lesions can read, write failure, miscalculation, and springing from the body parts of agnosia, as parietal lobe lesions cause motor and sensory aspects of early signs, less misdiagnosed as mental illness, parietal lobe tumor can occur when the integrated function of advanced sensory defects, patients with complex cognitive activities with many obstacles, bilateral parietal lobe lesions may cause difficulties in visual spatial and topographic disorientation judge.
The formation of the body like the parietal cortex, passing through proprioception results of comprehensive information, so a variety of parietal lobe tumors may present with body image disturbance, such as loss of awareness or neglect of one side (unilateral unawareness or neglect), hemi-body identified (hemisomatognosis) poor, disease agnosia (anosognosis), since the body parts of agnosia (autotopagnosia), duplication (reduplication phenomenon), physical synthesis is not (amorphosynthesis), etc., were not impaired sense of touch and pain, but can not touch to identify the objects, that is physical sensory disturbances (astereognosis), can not say a word or graphics program palm what is commonly known as writing a sense of loss, when the tumor spread to the occipital lobe visible when the rear looks agnosia.
Parietal lobe tumor patients may have depressed performance, personality disorders are less common, these patients on the self and surroundings (such as clothing) and so are not properly pay attention to the patient, there may be hesitation and difficulty dressing, as dressing apraxia disease (dressing apraxia) can sometimes lead to misdiagnosis as dementia or hysteria.
(5) the occipital lobe: the occipital lobe tumors are relatively rare, its cause mental symptoms mainly visual barriers to the most common visual hallucination, in addition to causing visual field defects, there is no clear limitation of symptoms, clinical produce contralateral to the hemianopia with , the main hemisphere lesions can have visual agnosia, that is, do not know that the objects and colors, while the posterior parietal lobe and temporal lobe contralateral lesions appear only 1 / 4 or 1 / 4 visual field defects, such as a pillow Ye irritating lesions, showing primitive visual hallucinations, occipital and temporal lobe tumor involving the parietal complex as the magic when the image of the tumor due here early cause increased intracranial pressure, may have a corresponding psychological symptoms.
(6) between the brain: The tumor can damage the hypothalamus, hypothalamus and adjacent third ventricle, can the performance of metabolism disorders, endocrine disorders, autonomic nervous system disorders, neuropsychiatric disorders, showing a more significant psychiatric symptoms, such as the obvious impairment of memory, intelligence decline, personality changes are: irritability, allergies, impulsivity, excitement, work irresponsible, careless, do not care about others, act childish, stupid, and personal habits and so on.
â‘ memory impairment: a tumor involving the third ventricle, 14% had memory deficit (Williams and Pennybacker, 1954), showed some forgotten - fiction syndrome, violations of the third ventricle between the brain and the craniopharyngioma, such as the exclusion cranial increased internal pressure factors, may also find a special memory impairment.
â‘¡ dementia: the cerebrospinal fluid circulation can cause chronic obstructive cortical atrophy, it is between the performance of brain tumors may have dementia, especially in middle-aged and elderly patients prone.
â‘¢ personality changes: brain tumor can be seen between the frontal lobe syndrome similar to the personality changes, such as decreased initiative, behavior childish, stupid humor, etc., but with frontal lobe damage differences between the brain lesions in patients with impaired insight does not .
â‘£ paroxysmal or periodic mental disorders: part of lesions between the brain can cause intermittent or cyclical changes in behavior of patients with major mood swings, sometimes depressed mood sometimes, or frequently lead to emotional control to reduce anger, confined between the brain No objective tumor visible excitement and stagnation phase alternating trance psychotic episode, each phase lasting 1 to 2 weeks, third ventricle colloid cysts may have a sudden start and sudden stop of the headache, delirium or confusion attack.
â‘¤ sleepiness - bulimia: a common cause of brain tumors between somnolence and sleep over, but can wake up, and some increased appetite, a localization diagnosis.
(7) Under the Canopy of the tumor: the spirit of infratentorial tumors less symptoms and more advanced stage of disease, these include the cerebellum, cerebellopontine angle, pons and medulla oblongata of the tumor, that is, posterior fossa tumors, cerebellar, and cerebellar pontine parts of the tumor The clinical manifestations in medulloblastoma and nerve sheath tumors mentioned, the lower pons and medulla oblongata in the brain stem, and if there are new episodes of biological growth, there may be silence, memory loss, slow thinking, emotional instability and confusion to consciousness loss has nothing to do with increased intracranial pressure, seizures continued short, only 3 ~ 10min, associated with heart rate, respiration, blood pressure, skin color, limb muscle tone changes, posterior fossa tumor patients before and after surgery the spirit prone to transient barriers, the time conscious, mainly for depression or paranoid psychosis.
(8) Central District: can the performance of irritation, the limitations of seizure for the contralateral limb, but also the development of generalized seizure.
(9) pituitary: the performance of lethargy, polyuria, obesity, sexual function changes, the limitations of amnesia, personality changes, and the uncus of temporal lobe epilepsy and other seizures, mental retardation, apathy, behavior, passive, indifferent to their own health, emotional instability, irritability or sudden anger is also common, or there paranoid state.
Must comply with the CCMD-2-R, the brain organic mental disorder diagnostic criteria and on the evidence of intracranial tumors, and the occurrence and course of mental disorders associated with brain tumors, brain tumors associated with psychiatric symptoms are not typical, behavioral changes, lack of positioning the signs and symptoms, diagnosis difficult, the first is based on medical history and physical examination to make early diagnosis of brain tumors.
The importance of early diagnosis of brain tumors, first of all should be clear: what whether the intracranial tumor, need to identify with other intracranial diseases; the site of tumor growth and the relationship with surrounding structures, accurate positioning for the craniotomy is very important ; the pathological nature, such as diagnosis can be done, determining the treatment and prognosis Jieyou reference value, history and clinical examination is the basis of correct diagnosis of brain tumors, time of onset, initial symptoms and subsequent onset of symptoms in the order of positioning diagnosis is important, headache, nausea, vomiting, and optic disc edema is a common physical symptoms 3, a psychiatrist in all patients with mental disorders should be carefully carried out physical examination and neurological examination of headache patients can not be taken lightly, long-term nature of headache in patients with headache change or new headache with no known cause, began to paroxysmal, persistent after, should pay particular attention to rule out brain tumors, intracranial tumors can show some short-term or special dysfunction, when the parietal l
Some parts of the tumor can lead to silence, lack of exercise, stress disorder and other similar lackluster performance, often misdiagnosed as tension-type schizophrenia, and foreign reports on misdiagnosis, misdiagnosed as schizophrenia, depression and a maximum of hysteria, a lot of brain Cancer patients showed depressive symptoms, and less associated with mania.
The patients were accompanied by family members to abnormal behavior, and if the situation has nothing to do with the development of the disease, and clinical course progresses, you should consider the possibility of brain tumors, cerebral symptoms without specific limitations, if any brain disease can be spread to these areas caused Therefore, combining history and laboratory examinations to be fully taken into account.