Brain Mets vs TIA

[SimonSez]

Hello Everyone,

I had a question regarding the work up of a patient with a known malignancy who presents with focal neurological deficits (TIA or Stroke). In such patients is it recommended to perform a contrast CT Brain or contrast MRI Brain to rule out Brain mets? Are there any guidelines that specify this? Also as a side question - how common is it for Prostate CA to metastasize to the Brain?

Thank you

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[gutonc]

Cancer patients with new focal or significant neuro sxs need an MRI brain with contrast.

CT head will be read as "negative for obvious intracranial pathology, recommend MRI if concerned for clinical situation warrants".

And while brain isn't the most common area for PCa mets, anything can happen.

PS, you're welcome for the medical advice.

 

[medgator]

Prostate often mets out to the bone, including, the base of skull, creating cranial neuropathies in some cases. Parenchymal brain mets from prostate much more rare. MRI will be your best bet.