Brain Tumor Mascerading as Neck Dysfunction
by Martin Krause
A Case Study : Cranial symptoms and Red Flags
59 year old women Mrs D. She presented November 2008. Symptoms started with gym exercises, walking lunges with medicine ball. Facial and occipital headaches. Some numbness reported around the cheeks and bridge of nose. History of Motor Vehicle Accident with a fractured sternum. X-rays of Cervical Spine demonstrated anterior osteophytes at C5/6 and reduced Intervertebral Foramen as well as Spinal Canal. Nil referred pain into arms or down trunk.
Dec 2008 Responding well to manual therapy, dry needling and exercises. However, still painful at night. Experimenting with various pillows. Dizziness with yoga moves (head on ground)
Jan 2009 Lazy right eye - to see specialist, having MRI/referral to spinal surgeon for Feb 09
March 2009 Wakes daily with headache.
May 2009 Cough increases pain
Sept 2009 Headache behind right eye, Advil "got rid of it"
Dec 2009 Very tired, taking mobic, neck really good. Still waking occasionally with headache
Jan 2010 Had a fall (leg went from under her). Jarred neck, getting worse. No neuro signs. Some dizziness generally not related to neck movement. Slight headache
8/1/10 Much better post treatment, no headaches, sleeping fine.
21/1/10 Bad nose bleed this morning. Got up then fell asleep in front of television
Feb 10 Pain with coughing. Mobic and Advil helps pain
17/2/10 Phoned to cancel appointment. Specialist and MRI, brain tumor behind eyes and nose "the size of a grapefruit" for surgery next week
Often late for treatment - reduced time for assessment and treatment
Having fairly regular physio over period from Nov 08 till Feb 10, with a 4 month respite in between to recommence gym program. Was always responding well to treatment
Odd symptoms "took for ever to get ready", I/T falls with no apparent reason, very tired
Signs and Symptoms of a Brain Tumor
Symptoms due to increased Intracranial Pressure (ICP)
- Early signs - headaches and nausea
- Headache much worse in the morning or when lying down (cough, sneeze, flexion, physical exertion or hiccups)
- More obvious symptom may be the development of epilepsy
- Later signs - drowsiness, may drop off to sleep during the day
- Sight changes - blurred vision, floating objects, tunnel vision - may cause confusion or affect balance
Symptoms due to Tumors position
Frontal lobe tumors - changes in personality and intellect. Uncoordinated walking or weakness of one side of body. Loss of smell, occasional speech difficulties
Parietal lobe - difficulty in expressing or understanding words, and problems with writing or reading. Difficulty in co-ordinating certain movements. Numbness or weakness on one side of the body.
Occipital lobe - loss of vision on one side. The person may not notice this at first and it may sometimes be discovered during routine eye tests.
Temporal lobe - fits may cause strange sensation; feeling of fear or intense familiarity (deja-vu), strange smells or blackouts. Occasional speech difficulties.
Cerebellum - lack of coordination which affects walking and speech (dysarthria), unsteadiness, flickering involuntary movement of the eyes (nystagmus). Vomiting and neck stiffness.
Brain Stem - unsteadiness and an uncoordinated walk. Facial weakness, a one-sided smile or drooping eyelid. Double vision. Rarely, vomiting or headache just after waking; difficulty in speaking and swallowing. Symptoms may appear gradually.
1 Jan 2011