Adult Brain tumors Flashcards
What is more common - Primary brain tumors or brain metastases?
Brain metastases
Types of glial tumors?
Astrocytoma, Ependymoma, oligodendroglioma
Are mixed glial tumors possible?
Yes
e.g. oligo-astrocytoma
Can tumors have both neuronal and glial components?
Yes
e.g. ganglioglioma
What can mimic a brain tumor?
Developmental Cysts
Types of nerve tumors?
Neurofibroma
Schwannomas
Most common primary brain neoplasms?
Infiltrative astrocytoma (42%) Glioblastoma mulitforme (GBM) (40%)
Intra-axial tumors?
Glioma, Pituitary, Lymphoma
Extra-Axial Tumors?
Meningioma
Acoustic Neuroma
Definite Risk factors for CNS Tumors?
Ionizing radiation
Immunosuppresion
Genetic Syndromes
Possible risk factors for CNS Tumors?
Electromagnetic fields
Diet
Occupation
Infections
Li-Fraumeni syndrome -Inheritance? Tumor type? Chromosome? Gene?
AD; Glioma, medulloblastoma; 17p13; TP53
Tuberous sclerosis -Inheritance? Tumor type? Chromosome? Gene?
AD; Subependymal giant cell astrocytoma, cortical tubers, glioma; 9q34, 16p13; TSC1, TSC2
Neurofibromatosis type 1 -Inheritance? Tumor type? Chromosome? Gene?
AD; Glioma(optic nerve), astocytoma, glioblastoma; 17q11; NF1
Neurofibromatosis type 2 -Inheritance? Tumor type? Chromosome? Gene?
AD; meningioma, schwannoma (bilateral acoustic neuroma), ependymomas; 22q12; NF2
Multiple Endocrine Neoplasia -Inheritance? Tumor type? Chromosome? Gene?
AD; Pituitary; 11q13; Menin
Retinoblastoma -Inheritance? Tumor type? Chromosome? Gene?
AD; Retinoblastoma; 13q14; RB1
Von Hippel-Lindau Disease -Inheritance? Tumor type? Chromosome? Gene?
AD; Hemangioblastoma; 3p25-20; VHL
What is the plateau wave phenomenon?
A phenomenon in which as intracranial volume slowly increase (e.g. tumor growth) intracranial pressure remains constant. However once compliance threshold is reached small volume increases cause large increase in intracranial pressure.
General signs and symptoms of CNS Tumors?
Headache
Vomiting
Mental status changes - depression, irritability, apathy
When should a headache lead you to suspect CNS tumor?
Worse on awakening with improvement within 1 hour
New onset at any age
Change in character or severity of headaches in chronic headache patient
Characteristics of vomiting associated with CNS tumors?
May or may not be associated with nausea
Occurs more often on awakening
More common in children
Focal signs and symptoms of CNS tumors?
Papilledema
Seizures
Focal neurologic deficits
Papilledema in CNS tumors is more often seen in whom?
Children and young adults
Subfalcine herniation of cingulate gyrus may cause?
Compression of ACA and CVA
Dienchephalic downward herniation may cause?
Compression of upper brainstem leading to drowsiness, impaired vertical gaze and uni- or bilateral small pupils because of involvement of sympathetic fibers (Horner Syndrome)
Classical uncal herniation may cause?
ipsilateral oculomotor nerve palsy and contra or ipsilateral hemiparesis
Upward herniation through tentorium may cause?
May cause ipsilateral oculomotor, Horner (mid position unreactive pupil) and contralateral hemiparesis