What is the treatment for a cerebellar lesion in the elderly?

Question

Hi doctor,

My mother, 84 years old, is hypertensive and diabetic. She had a minor head injury two weeks ago, and after two days, she developed dizziness and nausea. We had an MRI, which showed a cerebellar lesion. She was treated for breast cancer about five years ago, and uterus cancer only with surgery for about seven years ago.

She has been losing weight for the last two months. She had some dizziness for more than a year, but now it is much worse to the extent that she needs aid while walking; there are no localized neurological signs and no vertigo; GCS is 15. I want a neurosurgeon to look at the images and advise on the best treatment and the possibility of treating her at home due to the Coronavirus.

She currently takes Lisinopril and undergoes laboratory investigations, including FBC, LFT, and US and ES, which are all normal.

Please guide.

Answer 1

Hello,

Welcome to icliniq.com.

I am considering the history of cancer of the breast and uterus. There is a chance that this cerebellar lesion might be a metastasis.

I think she would require a detailed evaluation. PET-CT (positron emission tomography-computed tomography) and CECT (contrast-enhanced computed tomography) of the abdomen and thorax to rule out other metastases and the status of the primary disease. And as the cerebellar lesion is significant, it would require surgery.

PET-CT would be of significant prognostic value. If there are other lesions, then the prognosis is terrible. But if it is a solitary brain metastasis, then it indicates a relatively better prognosis. I think you should consult a neurosurgeon on a semi-emergent basis. Unfortunately, this situation is slightly complicated due to COVID-19.

I hope she gets well soon.

Thank you.