In the ED, their vitals/exam are as above. Today with new brain mass on ***. With*** s/s of midline shift. No evidence of elevated ICP today. With*** s/s of focal neurologic deficit today concerning for need for emergent neurosurgical intervention.
– Labs/Tests: Preop labs
– Imaging: Brain MRI (tumor protocol)
– Treatments: Dexamethasone 10mg loading dose -> 4mg q6h (hold if minimally symptomatic and likely obtaining biopsy as this would lower diagnostic yield), Keppra 500mg BID
– Consults: Neurosurgery, Neuro-oncology
– Dispo: Likely admission to Neurosurgery vs. Oncology