Astrocytoma physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Fahimeh Shojaei, M.D.

Overview

Common physical examination findings of astrocytoma include gait disturbances, Tachycardia or bradycardia, Orthostatic hypotension, reduced hearing acuity, nystagmus, abnormal extra-ocular movement, nonreactive pupils, papilledema, blurry vision, head tilt, Altered mental status, Clonus , Hyperreflexia, Muscle rigidity, proximal/distal muscle weakness unilaterally or bilaterally, cranial nerve involvement , unilateral/bilateral sensory loss in the upper/lower extremity, positive Trendelenburg's sign, unilateral/bilateral tremor and Dysmetria.

Physical Examination

NOTE: Based on the location of the tumor,we might have different signs and symptoms.

Appearance of the Patient

  • Patients are usually well appearing and can have gait disturbances.[1]

Vital Signs

Tumors which are located in the brain stem can cause heart rate and blood pressure disturbance:[2]

Skin

  • Skin examination of patients with astrocytoma is usually normal.

HEENT

  • Hearing acuity may be reduced
  • Nystagmus may be present
  • Extra-ocular movements may be abnormal
  • Pupils may not react to light
  • Ophthalmoscopic exam may be abnormal with findings of papilledema such as swollen disc, blurry vision, venous engorgement.

Neck

  • Head tilt may be present[3]

Lungs

  • Pulmonary examination of patients with astrocytoma is usually normal.

Heart

  • Cardiovascular examination of patients with astrocytoma is usually normal.

Abdomen

  • Abdominal examination of patients with astrocytoma is usually normal.

Back

  • Back examination of patients with astrocytoma is usually normal.

Genitourinary

  • Genitourinary examination of patients with astrocytoma is usually normal.

Neuromuscular

Extremities

  • Extremities examination of patients with astrocytoma is usually normal.

References

  1. Forbes JA, Mobley BC, O'Lynnger TM, Cooper CM, Ghiassi M, Hanif R; et al. (2011). "Pediatric cerebellar pilomyxoid-spectrum astrocytomas". J Neurosurg Pediatr. 8 (1): 90–6. doi:10.3171/2011.4.PEDS1115. PMC 3779306. PMID 21721894.
  2. Telerman-Toppet N, Vanderhaeghen JJ, Warszawski M (December 1982). "Orthostatic hypotension with lower brain stem glioma". J. Neurol. Neurosurg. Psychiatry. 45 (12): 1147–50. PMC 491700. PMID 7161610.
  3. Ansell P, Johnston T, Simpson J, Crouch S, Roman E, Picton S (January 2010). "Brain tumor signs and symptoms: analysis of primary health care records from the UKCCS". Pediatrics. 125 (1): 112–9. doi:10.1542/peds.2009-0254. PMID 20026498.
  4. Ansell P, Johnston T, Simpson J, Crouch S, Roman E, Picton S (January 2010). "Brain tumor signs and symptoms: analysis of primary health care records from the UKCCS". Pediatrics. 125 (1): 112–9. doi:10.1542/peds.2009-0254. PMID 20026498.
  5. Wilne SH, Ferris RC, Nathwani A, Kennedy CR (June 2006). "The presenting features of brain tumours: a review of 200 cases". Arch. Dis. Child. 91 (6): 502–6. doi:10.1136/adc.2005.090266. PMC 2082784. PMID 16547083.
  6. Wilne S, Collier J, Kennedy C, Koller K, Grundy R, Walker D (August 2007). "Presentation of childhood CNS tumours: a systematic review and meta-analysis". Lancet Oncol. 8 (8): 685–95. doi:10.1016/S1470-2045(07)70207-3. PMID 17644483.

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