Egyptian Journal of Neurosurgery (Sep 2024)
Management of patients with multiple brain metastases
Abstract
Abstract Metastases in the brain are a devastating and common cancer with a poor prognosis. Physicians, on the other hand, may help their patients by suspecting, recognizing, and treating them correctly. It is predicted that between 8 and 10% of cancer patients may develop brain metastases, resulting in roughly 200,000 new cases of brain metastases per year. Single and multiple metastases can share clinical, diagnostic, and therapeutic features. In the majority of brain metastasis, cancer cells move through the blood to the brain. The cerebellum is responsible for 15% of instances; whereas, the brainstem is responsible for 5%. The severity and speed with which the symptoms appear might vary substantially. In addition to the history and physical examination, CT and MRI with contrast give a safe, more sensitive diagnosis. The treatment is primarily palliative, although vigorous therapy in carefully selected patients can prolong the median survival time to about a year. Generally, the prognosis is guarded. Medical treatment includes corticosteroids and antiepileptic. Whole-brain irradiation, SRS, and chemotherapeutic agents are the most common adjuvant therapies. The neurosurgical approach to the management of such lesions has been greatly improved over the last few decades. Hereby, an updated review for the management of multiple brain metastasis.
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