Space Occupying Lesions (SOL) of the Brain - Clinical Manifestation with Subtle Neurological Symptoms in Emergency Department

Ahmed Sajjad

Department of Emergency, Rashid Hospital, P.O.Box:4545, Dubai, United Arab Emirates.

G. Y. Naroo *

Rashid Hospital Trauma Centre, Dubai, United Arab Emirates.

Zafar Khan

Department of Emergency, Rashid Hospital, P.O.Box:4545, Dubai, United Arab Emirates.

Zulfiqar Ali

Department of Emergency, Rashid Hospital, P.O.Box:4545, Dubai, United Arab Emirates.

Bina Nasim

Department of Internal Medicine, Rashid Hospital, P.O.Box:4545, Dubai, United Arab Emirates.

Anis Sheikh

Department of Emergency, Rashid Hospital, P.O.Box:4545, Dubai, United Arab Emirates.

Hussain Shah

Department of Emergency, Rashid Hospital, P.O.Box:4545, Dubai, United Arab Emirates.

Laji Mathew

Department of Emergency, Rashid Hospital, P.O.Box:4545, Dubai, United Arab Emirates.

Nayeem Rehman

Department of Emergency, Rashid Hospital, P.O.Box:4545, Dubai, United Arab Emirates.

Tanvir Yadgir

Dubai Corporation for Ambulance Services, United Arab Emirates.

*Author to whom correspondence should be addressed.


Abstract

A space-occupying lesion of the brain is commonly due to malignancy but could be other underlying pathologies as well [1]. The effects of SOL may be local or due to compression of adjacent brain structures. Patients may also have behavioral disturbances or cognitive dysfunction [2,3].

Aims & Objectives:

           1. To identify SOL patients presenting with elusive symptoms in Emergency Department.
           2. To avoid diagnostic delay of SOL.
           3. To find the underlying cause and to initiate early management.

Methods: This is a retrospective study involving 150 patients who presented in ED Rashid Hospital with neurological symptoms over a period of 12 months commencing from 01/01/2015 until 31/12/2015.

Results: As for presenting symptoms, 81 (54%) presented with Seizures, 31 (21%) with a headache, 17 (11%) had both a headache and vomiting, 8 (5%) with unconsciousness and those by abnormal behavior (3%). Five (3%) were having a motor deficit, and two (1%) had vomiting without a headache and confusion.

As for underlying diagnosis, 78 (52%) were diagnosed with infectious causes and 62 (41%) with a brain tumor. Among the infectious causes, 58 (74%) presented with seizures, 11 (14%) with an isolated headache and 4 (5%) with both a headache and vomiting.

On the other hand, the headache was the commonest presentation in brain tumor patients, i.e., 18 (29%) followed by seizures in 17 (27%), headache and vomiting in 11 (18%) and neurological deficit in 10 (16%) patients.

Conclusion: A headache with or without vomiting, seizure and acute psychological disturbances may be a warning sign of a wide variety of an intracranial space occupying lesion (SOL) including malignancy.

Keywords: Space-occupying lesion, headache, brain tumor, seizure, emergency department (ED)


How to Cite

Sajjad, Ahmed, G. Y. Naroo, Zafar Khan, Zulfiqar Ali, Bina Nasim, Anis Sheikh, Hussain Shah, Laji Mathew, Nayeem Rehman, and Tanvir Yadgir. 2018. “Space Occupying Lesions (SOL) of the Brain - Clinical Manifestation With Subtle Neurological Symptoms in Emergency Department”. Journal of Advances in Medicine and Medical Research 26 (3):1-8. https://doi.org/10.9734/JAMMR/2018/38701.

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