Profil Gangguan Kognitif pada Tumor Intrakranial Primer dan Metastasis

Brain tumor patients are often accompanied by a wide range of cognitive impairment as a major cause of disablility. The different pathophysiology of primary and metastatic brain tumor influences patients’ clinical signs and symptoms, and also the severity of cognitive impairment. To determine the prevalence and profile of cognitive impairment in patients with primary and metastatic brain tumors, this cross-sectional study was done on subjects of 18 to 65 years old with the diagnosis of primary and metastatic brain tumors based on anamnesis, physical examination, imaging modalities, and/or histopathology results. Subjects underwent cognitive and neuropsychology assessment in Neurology Outpatient Clinics, Cipto Mangunkusumo Hospital, from January 2011 to December 2013. From 121 subjects, 79 were primary and 27 were metastatic brain tumor patients. The metastatic tumor group mean of age were older than the primary tumor group (50,9 and 43,7 years respectively). In metastatic group, majority of subjects had bilateral lesion (40,7%) and localized in more than 1 lobe (51,9%), compared to primary tumor who had single lobe and one hemispheric lesion. Cognitive impairment was mostly found in metastatic brain tumor group (81,5%) rather than primary (52,5%) and also more severe in metastatic group (MMSE mean 20,96 and 22,61 respectively) with visuospatial impairment as the most common disorder. Cognitive impairment was much higher in metastatic brain tumor compared to primary brain tumor, with more severe degree of cognitive impairment because majority of lesion affected more than 1 lobe.