Metastatic Tumours of the Brain

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Abstract
Metastatic tumours of the brain are comparatively common, and constitute about 20% of all intracranial tumours. They may be derived from primary growths in any part of the body, but the lung and the breast are the most important sources. In most cases the tumours are multiple and blood-borne, and originate at the junction of the grey and white matter or in the central grey masses. More rarely a diffuse invasion of the meninges is encountered. Clinically they are characterized by a sudden or rapid onset, in middle-aged persons, of symptoms of which the most striking are intense and intractable headache out of proportion to the degree of intracranial pressure, symptoms of destruction of conducting pathways, and epileptic episodes. Wasting is severe, and the progress of the disease rapid. Although cerebral manifestation may precede any obvious evidence of the primary growth, symptoms suggestive of primary disease elsewhere can usually be elicited and its presence confirmed by special investigations, of which X-ray examination of the chest is most valuable. Treatment should be confined to those cases which experience pain, and should consist of an extensive decompression at the site of the clinical localization.