CENTRAL NERVOUS SYSTEM

Conditions affecting the central nervous system (CNS) that may require intervention may be classified as follows:

  • Congenital disorders (hydrocephalus, microcephaly, encephaloceles, etc.)
  • Degenerative disorders
  • Vascular disorders
  • Infections (e.g., brain abscesses)
  • Neoplasms
  • Trauma

(See neurosurgical textbooks for greater detail.)

Clinical Features

The features may be generalized or localized. A detailed history and careful examination are necessary to an accurate diagnosis.

  1. Generalized features
    • Headache
    • Vomiting
    • Alterations in level of consciousness.
  2. Localized features
    • Paralysis and/or sensory defect of a part of the body
    • Diplopia
    • blurred vision or loss of vision

Investigations

  • Full haemogram (severe anaemia should arouse suspicion of metastatic disease and polycythaemia of cerebellar haemangio blastemas)
  • Plain radiography (will for example show metastatic disease of the skull, expansion of sutures in children, eroded clinoid processes, vascular markings and hyperostosis in meningiomas, etc.)
  • Contrast radiology (ventriculography, angiography, etc.)
  • Computerized axial tomography (CT scan) is the main diagnostic tool today for intracranial lesions