Parasagittal meningioma
Tumour: Parasagittal meningioma
Typical presentation
Gradually progressive contralateral lower limb weakness
Focal seizures in the leg
UMN signs
Why
Compression of the Paracentral lobule (leg area of the Primary motor cortex).
Exam clue
Progressive leg weakness + seizures ā parasagittal meningioma.
Acoustic neuroma (vestibular schwannoma)
Tumour: Vestibular schwannoma
Typical presentation
Unilateral hearing loss
Tinnitus
Balance problems
Later:
Facial numbness
Facial weakness
Why
Compression of:
Vestibulocochlear nerve (CN VIII)
Facial nerve (CN VII)
Exam clue
Progressive unilateral deafness.
Pituitary adenoma
Tumour: Pituitary adenoma
Typical presentation
Bitemporal hemianopia
Why
Compression of the Optic chiasm.
Other clues:
Hormonal symptoms (galactorrhoea, acromegaly, Cushing's).
Exam clue
Loss of temporal visual fields.
Cerebellopontine angle tumour
Often a Vestibular schwannoma.
Symptoms
Hearing loss
Facial numbness
Ataxia
Structures involved:
Trigeminal nerve
Facial nerve
Vestibulocochlear nerve
Exam clue
Multiple cranial nerve deficits in the cerebellopontine angle.
Frontal lobe tumour
Commonly a Glioma.
Typical presentation
Personality change
Disinhibition
Poor judgement
Sometimes urinary incontinence
Structure affected:
Frontal lobe
Exam clue
Behavioural change before neurological deficit.
ā
Very high-yield MRCS pattern
Symptom Likely tumour
Leg weakness Parasagittal meningioma
Unilateral deafness Vestibular schwannoma
Bitemporal hemianopia Pituitary adenoma
Behaviour change Frontal lobe tumour
Multiple cranial nerve palsies CPA tumour