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Medical Author:

Charles Patrick Davis, MD, PhD

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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Medical Editor:

Steven Doerr, MD

Steven Doerr, MD

Steven Doerr, MD, is a U.S. board-certified Emergency Medicine Physician. Dr. Doerr received his undergraduate degree in Spanish from the University of Colorado at Boulder. He graduated with his Medical Degree from the University Of Colorado Health Sciences Center in Denver, Colorado in 1998 and completed his residency training in Emergency Medicine from Denver Health Medical Center in Denver, Colorado in 2002, where he also served as Chief Resident.

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An accurate medical history, family history and physical exam may often allow a presumptive diagnosis to be made by the doctor. However, in most situations, the physician will conduct other tests to gather further data and information in order to establish a definitive diagnosis. Although various blood tests may be ordered, imaging studies of the brain using CT scan or MRI will likely be the most important tests to evaluate and visualize brain lesions. The type of imaging study initially ordered will generally depend on the signs and symptoms of the patient.

A lumbar puncture (spinal tap) may also be performed to evaluate for meningitis or other neurologic conditions, depending on the clinical scenario. In addition, some patients may undergo neurological and physiological testing. All of these tests are important because they may yield evidence that a condition other than a brain lesion is causing the patient's problem. Alternatively, the tests may provide definitive evidence that the presumptive diagnosis suspected of causing a brain lesion is correct.

However, sometimes the definitive diagnosis is made by a tissue biopsy of the brain lesion. A surgeon, using small instruments, can remove a sample of brain tissue, which can then be examined microscopically, leading to a final diagnosis (and grading of the brain lesion if it is cancer). In some situations, such as brain lesions due to trauma, a biopsy is not necessary for a diagnosis. In other situations, the diagnosis is not confirmed until autopsy (for example, many people with Alzheimer's disease).

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