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[Brain metastases in adults].

Torstein R Meling1, Eirik Helseth, Geirmund Unsgård

  • 1Nevrokirurgisk avdeling, Rikshospitalet, 0027 Oslo. torsteinrmeling@mailcity.com

Tidsskrift for Den Norske Laegeforening : Tidsskrift for Praktisk Medicin, Ny Raekke
|September 3, 2005
PubMed
Summary

Brain metastases, often from lung or breast cancer, are common. Diagnosis uses cerebral MRI, with prognosis depending on Karnofsky score, age, and cancer control. Treatment options include surgery or gamma knife, with gamma knife often preferred for its minimally invasive nature.

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Area of Science:

  • Neuro-oncology
  • Neurosurgery
  • Medical imaging

Context:

  • Brain metastases are significantly more prevalent than primary brain tumors.
  • Clinical experience and a decade of Medline literature inform this overview.
  • Understanding the origin and spread of extracranial tumors to the brain is crucial.

Purpose:

  • To provide a comprehensive overview of the diagnosis and treatment of brain metastases.
  • To highlight key prognostic factors influencing patient survival.
  • To compare the efficacy and indications for surgical versus gamma knife interventions.

Summary:

  • Brain metastases originate from extracranial primary tumors (lung, breast, melanoma, renal, colorectal) and commonly present as multiple lesions.
  • Cerebral Magnetic Resonance (MR) imaging is the most sensitive diagnostic tool.

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  • Prognostic indicators include Karnofsky score, age under 65, controlled primary cancer, and absence of systemic disease.

    • Impact:

    • Informs clinical decision-making for neurosurgical interventions (surgery vs. gamma knife).
    • Gamma knife is often preferred for smaller, deep-seated, or eloquent tumors due to lower morbidity and shorter hospital stays.
    • Highlights the importance of a multidisciplinary approach in managing brain metastases.