The Patient with an Intracranial Tumor
A 49-year-old right-handed man came to the hospital complaining of right-sided weakness and dysphagia. There were no sensory changes and no weight loss. He gave a long history of hypertension. Past surgical history was significant for left thoracotomy and upper lobectomy for carcinoma 1 year previously. Medications consisted of hydrochlorothiazide, dexamethasone, Cimetidine, and acetaminophen. He had no allergies and had smoked two packs of cigarettes daily for 30 years. He had continued to smoke since his surgery last year.
Physical examination revealed a well-developed male with a mild right facial palsy; blood pressure was 130/70 mmHg; pulse, 80/min; respiratory rate, 12/min; height, 5ft 8in; weight, 176 lb. Examination results for the heart and lungs were normal. Neurologic examination showed 4/5 hemiparesis, no sensory deficits, and brisk reflexes with no clonus on the right side.
Laboratory data: hematocrit, 42%; SMA-12, normal; ECG, nonspecific ST-, T-wave changes; chest x-ray, inflation of the left upper lung fields, surgical clips noted. CT scan showed a left frontal ring enhancing lesion with much surrounding edema and mass effect. He was scheduled for left frontoparietal craniotomy.
KeywordsCerebral Blood Flow Mean Arterial Pressure Pituitary Adenoma Intracranial Pressure Intracranial Hypertension
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