First Things First (assess & treat for the following)

• Tumors that metastasize to the brain occur in ~10-15% of systemic cancers.
• The cancers w/ the greatest incidence of brain & intracranial metastasis (85%) are:
  • Lung
    • The most common cancer to metastasize to the brain
    • 50% of the metastases are single lesions.
  • Breast
    • 10-30% of advanced breast cancer metastasizes to the brain.
    • Usually occurs in younger & premenopausal pts
  • Malignant melanoma
    • 30-40% incidence of metastatic intracranial tumors
    • Usually multiple & hemorrhagic
  • Renal cell
    • Metastatic tumors also appear to be highly vascular.
    • They are more likely to be solitary tumors.
  • Colorectal
    • Colorectal tumors are infrequently metastatic to the brain.
    • Solitary metastases most frequently seen in posterior fossa
• Any disease presenting as a space-occupying lesion or cerebral edema is suspect:
  • Intracranial abscess
  • Intracranial infection: parasitic
  • Hematomas
  • Tumors
  • Generalized cerebral edema