Astrocytoma physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ammu Susheela, M.D. [2]

Overview

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

  • Patient is usually oriented to persons, place, and time
  • Altered mental status
  • Glasgow coma scale is 15 / 15
  • Clonus may be present
  • Hyperreflexia may be present
  • Muscle rigidity
  • Proximal/distal muscle weakness unilaterally or bilaterally
  • Cranial nerve involvement may be present.
  • Unilateral/bilateral sensory loss in the upper/lower extremity
  • Abnormal gait may be present (trunkal ataxia)
  • Positive Trendelenburg sign may be present
  • Unilateral/bilateral tremor
  • Dysmetria may be present[4]

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.

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