Central nervous system disorders

VI./4.4.: Differential diagnosis

The most important diagnostic and differential diagnostic method in case of brain metastases are the different and complement neuroradiologic investigations done and their result integrated with the clinical information. Further investigation of solitary or multiple, ring-enhancing lesions are different. Solitary metastatic tumors have to be distinguished from primary brain tumors. Cerebral abscess may be hard to differentiate from tumor, since it could be multiple, similarly enhance contrast material or trigger large perifocal oedema around.

Mycotic or protozoon infections may even grow similar to a tumor. At first sight, the CT scan image of a haemorrhagic ischemic lesion or tumor could be mixed, but MRI investigation and the accurate case history help to differentiate. Radiation necrosis and recurrent metastasis have to be precisely distinguished in postoperative care and follow-up (7).