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Mr. Yeoh Ah Peng, 46, examination, sign & symptoms, risk factors,…
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sign & symptoms
persistent headache (generalized, common in the morning; not relieved by paracetamol)
increase ICP; worse in the morning d/t recumbency, decrease CSF absorption & rise in PCO2 d/t respiratory depression
vomitting
increase ICP, activate mechanoreceptor stimulating chemotactic trigger zone in area postrema
seizure (on right side, lasted a minute)
irritated grey matter; gliosis & chronic inflammatory changes in surrounding normal brain causing excitotoxicity in adjacent neurons; tumor on left brain hemisphere affect right side of the body
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investigation
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MRI: well-defined hypointense lesion in the left cerebral hemisphere with little enhancement of the border zone
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