Brain Clinical Flashcards
name 3 common primary brain tumours
> glioma (neuroepithelal tissue)
meningioma
adenoma
name the commonest tumours that spread to the brain
> renal cell carcinoma > lung carcinoma > breast carcinoma > malignant melanoma > gi tract
what cells are gliomas derived from?
astrocytes
what is the WHO grade for gliomas?
IV
how do gliomas spread?
by tracking through white mater and CSF pathway
are meningiomas slow growing or fast growing?
slow growing
from what do meningiomas arise from?
arachnoid mater
true or false meningiomas are usually benign
true
where do meningiomas frequently occur?
> along the falx
convexity
sphenoid bone
how do pituitary tumours often present?
> visual disturbance
> hormone imbalance
how may brain tumours present?
> raised intracranial pressure
focal neurological deficit
epileptic fits
CSF obstruction
name some symptoms of raised intracranial pressure
> headache > nausea/vomiting > visual imbalance > somnolence > cognitive impairment > altered consciousness
name some signs of raised intracranial pressure
> papilloedema > 6th nerve palsy > cognitive impairment > altered consciousness > 3rd nerve palsy
gives some examples of focal neurological deficits
> hemiparesis > dysphasia > hemianopia > cognitive impairment > cranial nerve palsy > endocrine disorders
a patient presents with bitemporal hemianopia. where would you suspect their lesion is?
in the pituitary
a right handed patient presents with difficulty reading and expressing what they wish to say.
where may you suspect the lesion is?
left temporo-parietal area
what lesions cause epilepsy?
lesions above the tentorium
what investigations can be carried out for adequate cerebral imaging?
> CT
MRI
PET
angiography
what investigations could be carried out if metastasis if suspected?
> CT chest/abdo/pelives
mammography
skin lesion and lymph node biopsy
what are the management options for a glioblastoma multiforme?
> medical: steroids, anticonvulsants
radiotherapy
chemotherapy (temazolamide)
what management options are there for metastasis?
> medical: steroids and anticonvulsants
radiotherapy
surgery
what is the management for a meningioma?
surgery and anticonvulsants
what is the prognosis in an astrocytoma?
> low grade there is a long life expectancy
> high grade there is a 1year average
there are signs and symptoms suggesting an intracranial mass lesion.
should you perform a lumbar puncture?
NO DO NOT PERFORM A LUMBAR PUNCTURE!!!!!!!!!!!
why shouldn’t you perform a lumbar puncture if there is an intracranial mass lesion?
> might causes meningitis
could cause herniation symptoms
could cause air embolism
make headache worse
