Brain Clinical

Question 1

name 3 common primary brain tumours

Answer 1

> glioma (neuroepithelal tissue)
meningioma
adenoma

Question 2

name the commonest tumours that spread to the brain

Answer 2

> renal cell carcinoma
> lung carcinoma
> breast carcinoma
> malignant melanoma
> gi tract

Question 3

what cells are gliomas derived from?

Answer 3

astrocytes

Question 4

what is the WHO grade for gliomas?

Answer 4

IV

Question 5

how do gliomas spread?

Answer 5

by tracking through white mater and CSF pathway

Question 6

are meningiomas slow growing or fast growing?

Answer 6

slow growing

Question 7

from what do meningiomas arise from?

Answer 7

arachnoid mater

Question 8

true or false meningiomas are usually benign

Answer 8

true

Question 9

where do meningiomas frequently occur?

Answer 9

> along the falx
convexity
sphenoid bone

Question 10

how do pituitary tumours often present?

Answer 10

> visual disturbance

> hormone imbalance

Question 11

how may brain tumours present?

Answer 11

> raised intracranial pressure
focal neurological deficit
epileptic fits
CSF obstruction

Question 12

name some symptoms of raised intracranial pressure

Answer 12

> headache
> nausea/vomiting
> visual imbalance
> somnolence
> cognitive impairment
> altered consciousness

Question 13

name some signs of raised intracranial pressure

Answer 13

> papilloedema
> 6th nerve palsy
> cognitive impairment
> altered consciousness
> 3rd nerve palsy

Question 14

gives some examples of focal neurological deficits

Answer 14

> hemiparesis
> dysphasia
> hemianopia
> cognitive impairment
> cranial nerve palsy
> endocrine disorders

Question 15

a patient presents with bitemporal hemianopia. where would you suspect their lesion is?

Answer 15

in the pituitary

Question 16

a right handed patient presents with difficulty reading and expressing what they wish to say.
where may you suspect the lesion is?

Answer 16

left temporo-parietal area

Question 17

what lesions cause epilepsy?

Answer 17

lesions above the tentorium

Question 18

what investigations can be carried out for adequate cerebral imaging?

Answer 18

> CT
MRI
PET
angiography

Question 19

what investigations could be carried out if metastasis if suspected?

Answer 19

> CT chest/abdo/pelives
mammography
skin lesion and lymph node biopsy

Question 20

what are the management options for a glioblastoma multiforme?

Answer 20

> medical: steroids, anticonvulsants
radiotherapy
chemotherapy (temazolamide)

Question 21

what management options are there for metastasis?

Answer 21

> medical: steroids and anticonvulsants
radiotherapy
surgery

Question 22

what is the management for a meningioma?

Answer 22

surgery and anticonvulsants

Question 23

what is the prognosis in an astrocytoma?

Answer 23

> low grade there is a long life expectancy

> high grade there is a 1year average

Question 24

there are signs and symptoms suggesting an intracranial mass lesion.
should you perform a lumbar puncture?

Answer 24

NO DO NOT PERFORM A LUMBAR PUNCTURE!!!!!!!!!!!

Question 25

why shouldn’t you perform a lumbar puncture if there is an intracranial mass lesion?

Answer 25

> might causes meningitis
could cause herniation symptoms
could cause air embolism
make headache worse