Pathophysiology

A delicate balance of normal pressure is maintained in the brain and spinal cord by brain, blood, and cerebrospinal fluid. Since the brain is contained within a confined space (skull), any foreign mass contained within that space causes adverse sequelae. This results in either destruction or displacement of normal brain tissue with associated edema. Most brain metastases occur through hematogenous spread of the primary tumor and around 80% of patients will have multiple sites of metastases within the brain.

Patients with brain metastases may have no symptoms. Alternatively, they may have severe headaches, vision changes, and personality/mood disturbances depending on the location of the metastasis. Diagnosis is made based on physical signs and symptoms and brain CT or MRI which indicate a mass.

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