For patients with malignancy the principle causes of raised intracranial pressure (ICP) will be the presence of space-occupying tumours or obstructive hydrocephalus
Clinical features
Headache with nausea is very telling (chronic daily headache can be the first presentation)
Weakness can stutter along and present with very vague symptoms i.e. apraxia instead of true weakness
Other symptoms: vomiting, personality change, memory loss, visual disorder, seizures
Symptoms can be triggered by small bleeds within tumours
Investigations
Neurological exam: including for papilloedema
Imaging: CT and MRI (MRI better for detail)
Management
Surgery (invasive) but does have a role in limited disease
Radiotherapy
Steroids to reduce oedema (helps headache and neuro symptoms)
Glioblastoma multiforme - often large lesion with satellite lesions
Surgical debulking prolongs life with symptom control
Treat seizures as per local protocol
Driving advice and safety advice
Lifelong antiepileptic medication
Steroids to reduce oedema
Radiotherapy can follow but in the immediate period (2-3 weeks) likely to worsen oedema and performance status