Abstract
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A.
Local effects of tumors
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1.
Infiltration, invasion, and destruction of normal central nervous system tissues by tumor produces focal neurological signs
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2.
Mass of tumor produces direct pressure on neural structures causing degeneration (although brain and spinal cord can adjust remarkably to gradually increasing pressure)
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3.
Compromise of local circulation due to direct pressure on capillaries and small arteries and veins can be associated with local tissue necrosis or more distant infarction
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4.
Brain edema — usually greatest around tumor; can interfere with functioning of more remote neural tissue, adding to clinical symptoms directly attributable to tumor mass and eventually (usually over period of months) resulting in demyelination and astrocytic hyperplasia in white matter
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a.
Treatment with high doses of corticosteroids can reduce edema
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b.
Osmotic agents (such as intravenous infusion of hypertonic solution of mannitol) can very rapidly decrease intracranial pressure
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a.
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5.
Seizures — tumors involving cerebral cortex can result in focal or generalized seizures
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6.
Spinal involvement — symptoms depend on level of tumor and whether extramedullary or intramedullary
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a.
Extramedullary tumors — growth outside spinal cord parenchyma produces symptoms related to nerve root compression and bone destruction before spinal cord symptoms
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b.
Intramedullary tumors — because of small size of spinal cord, tumor growth within cord parenchyma presents early as disturbance of spinal cord function (disruption of long tracts and local segmental signs)
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a.
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1.
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Suggested Additional Reading
Burger PC, Scheithauer BW, Vogel FS: Surgical Pathology of the Nervous System and Its Coverings, 3rd ed. New York, Churchill Livingstone Inc, 1991.
Harkin JC, Reed RJ: Tumors ofthe Peripheral Nervous System. Atlas of Tumor Pathology. Second Series. Fascicle 3. Washington, DC, Armed Forces Institute of Pathology, 1969.
Kovacs K, Horvath E: Tumors of the Pituitary Gland. Atlas of Tumor Pathology. Second Series. Fascicle 21. Washington, DC, Armed Forces Institute of Pathology, 1986.
Reed RJ, Harkin JC: Supplement. Tumors ofthe Peripheral Nervous System. Atlas ofTumor Pathology. Second Series. Fascicle 3. Washington, DC, Armed Forces Institute of Pathology, 1982.
Rubinstein LJ: Supplement. Tumors of the Central Nervous System. Atlas of Tumor Pathology. Second Series. Fascicle 6. Washington, DC, Armed Forces Institute of Pathology, 1982.
Rubinstein LJ: Tumors of the Central Nervous System. Atlas of Tumor Pathology. Second Series. Fascicle 6. Washington, DC, Armed Forces Institute of Pathology, 1972.
Russell DS, Rubinstein LJ: Pathology of Tumors ofthe Nervous System, 5th ed. Baltimore, Williams & Wilkins, 1989.
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Brumback, R.A. (1993). Central Nervous System Neoplasms. In: Neurology and Clinical Neuroscience. Oklahoma Notes. Springer, New York, NY. https://doi.org/10.1007/978-1-4684-0456-2_11
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