Brain Lesions (Lesions on the Brain)

  • Medical Author:
    Benjamin Wedro, MD, FACEP, FAAEM

    Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

  • Medical Editor: Charles Patrick Davis, MD, PhD
    Charles Patrick Davis, MD, PhD

    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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How are brain lesions diagnosed?

The diagnosis of a brain lesion begins with the health care practitioner taking a history and asking the patient questions about the symptoms such as:

  • When did they start?
  • Do they come and go or are they constant?
  • ave they progressed over time?
  • What makes them better or worse?

Depending upon the circumstances, the patient may not have insight or may not remember the symptoms or complaints, and it may be up to a family member, caregiver, or friend to supply the appropriate information.

Medical history and physical exams

Past medical history of the patient, exploring associated symptoms and complaints may be helpful in determining the diagnosis.

Physical examination is very helpful in trying to localize a potential brain lesion. A careful neurologic exam may be useful in finding weakness, change in sensation (including light touch, pain, vibration, and position sense), and coordination. Mental status, agility, other organ systems are often assessed. For example, patients who have an irregular heart rate called atrial fibrillation are at risk for stroke. Stroke risk may also be increased in patients with carotid stenosis and the health care practitioenr may listen over the neck for a bruit (an abnormal sound made by blood rushing through a narrowed carotid artery).

Imaging and other tests

Depending upon the clinical situation, imaging of the brain such as computerized tomography (CT) andmagnetic resonance imaging (MRI) may be useful in making the diagnosis of a brain lesion. Angiography can be added to either CT or MRI to visualize the blood vessels in the brain.

Lumbar puncture (spinal tap) is often considered to evaluate the cerebrospinal fluid (CSF) for infection, bleeding, or abnormal proteins; depending upon the clinical situation.

Blood tests are usually preformed, to explore any illnesses that can also involve the brain.

Medically Reviewed by a Doctor on 5/7/2015
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