- Evaluation
- A careful history and physical examination are necessary to verify symptoms and correlate imaging findings. It is important to rule out non-neoplastic causes of mass lesions.
- Lesions that mimic tumour
- Infectious sources: Toxoplasmosis,
- Vascular events such as evolving infarction
- Inflammatory factors such as sarcoidosis, and autoimmune causes such as multiple sclerosis.
- Some tumours are very amenable to radiation therapy and do not require surgical resection.
- Germinomas,
- Lymphomas,
- Cerebral multiple myeloma and leukaemia
- These should be confirmed with CSF studies or stereotactic biopsy
- Pre op tumour embolization can be done for
- Glomus jugulare,
- Hemangiopericytoma, and
- Solid hemagioblastoma of the posterior fossa
- Anesthetic agent
- Maintenance of anesthesia is best obtained with volatile agents, preferably isoflurane, small doses of narcotics, and muscle relaxants. Isoflurane also decreases the cerebral metabolic rate of oxygen. Of note, isoflurane is known to slightly increase ICP.
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