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Neuro > Brain tumors > Flashcards

Brain tumors Flashcards

1
Q

How common is brain cancer

A

9th most common

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2
Q

what are neuroepithelial split into

A

glial cells
neurones

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3
Q

what are glial cells split into

A
  • astrocytes
  • ependymal cells
  • oligodendrocytes
  • microglial
  • neurones
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4
Q

acoustic neuroma affects what nerve

A

8th

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5
Q

from what primary cancers metastsise to the brain

A

Lung
Breast
Colorectal
Testicular
Renal cell
Malignant melanoma

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6
Q

how are brain tumors graded

A

according to how fast they grow and how likely they are togrow back after treatment.

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7
Q

What system do we use and not use

A

NO- TNM TUMOR NODE METASTASIS
YES- WHO

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8
Q

What is the most common primary brain tumor

A

glioma

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9
Q

Grade 1 Brain tumour

A

Slow growing, non-malignant, and associated with long-term survival

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10
Q

Grade 2 Brain tumour

A

Have cytological atypia. These tumours are slow growing but recur as higher-grade tumours.

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11
Q

Grade 3 Brain tumour

A

Have anaplasia and mitotic activity. These tumours are malignant

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12
Q

Grade 4 Brain tumour

A
  • Anaplasia, mitotic activity with microvascular proliferation, and/or necrosis.
  • These tumours reproduce rapidly and are very aggressive malignant tumours
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13
Q

What are neuropeithelial cells??

A

stem cells that differentiate into neurons and glial cells.

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14
Q

What are glial cells

A
  • non-neuronal cells in the central nervous system (brain and spinal cord) and the peripheral nervous system that do not produce electrical impulses.
  • They maintain homeostasis, form myelin, and provide support and protection for neurons.
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15
Q

What are astrocytes

A
  • supportive role - maintain brain homeostasis and neuronal metabolism.
  • They provide neurons with mechanical support, control neuronal cell development, plasticity and synaptogenesis,
  • release nutritional and energy like glucose and lactate and play a role in neurotransmission, vasomodulation and repair.
  • Astrocytes also maintain and control the concentrations of ions, neurotransmitters and metabolites and regulate water movements.
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16
Q

why can low grade gliomas not show any symtoms for up to 5 years

A

brain plasticity , as tumor grows the brain moves out of the way

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17
Q

what is anaplasticity

A

A term used to describe cancer cells that divide rapidly and have little or no resemblance to normal cells

18
Q

What are oligodendrocytes

A

produce the myelin sheath insulating neuronal axons

19
Q

average survival rate of low grade gliomas

A

10 yrs
median age - 35 years

20
Q

Features of High Grade Gliomas - 3 and 4

A
  • Most common type - 85% of all new cases of malignant primary brain tumour
  • Either as primary tumour or from pre-existing low grade
  • Survival time longer than de novo high grade glioma
  • Median age onset 45 for III, 60 for IV
  • Survival times III – 3-5 years IV – 12 months
21
Q

What are the Known causes of Brain Tumours?

A
  • Majority no cause found
  • Ionising radiation
  • 5% family history
  • Associated genetic syndromes: neurofibromatosis, tuberose sclerosis, Von Hippel-Lindau disease
  • Immunosuppression (CNS lymphoma)
  • No evidence to link mobile phone use
22
Q

symptoms of brain tumor

A
  • Headache
  • Seizures
  • Focal neurological symptoms
  • Other non-focal symptoms
23
Q

features of headache

A
  • Woken by headache,
  • worse in the morning,
  • worse lying down,
  • associated with N&V,
  • exacerbated by coughing, sneezing, drowsiness
24
Q

focal symptoms

A
  • Weakness
  • Sensory loss
  • Visual/speech disturbance
  • Ataxia
25
Q

non focal symptoms

A
  • Personality change/behaviour
  • Memory disturbance
  • Confusion
26
Q

reccurent de ja vu or memories would make you think

A

tumor in temporal lobe

27
Q

signs of brain tumor

A

Papilloedema
Focal neurological deficit

28
Q

focal neurologial deficit could exhibit as ?

A

Hemiparesis
Hemisensory loss
Visual field defect
Dysphasia

29
Q

presentation of low grade tumor

A

typically present with seizures (can be incidental finding).

30
Q

high grade tumors present as

A
  • rapidly progressive neurological deficit.
  • Symptoms of raised intracranial pressure.
31
Q

red flags for tumor

A
  • Headache with rasied intracranial pressure with focal neurology
  • check for focal defects
32
Q

for what reasons would you do an urgent referral

A
  • New onset focal seizure
  • Rapidly progressive focal neurology (without headache)
  • Past history of other cancer
33
Q

investigations ?

A
  • CT - with contrast
  • MRI - better for pituitary lesions
  • opthamologiacal
34
Q

Once you have found a tumor what do you do

A
  • brain biopsy
  • surgery
35
Q

tx ?

A
  • depends on grade, location
  • treatment is non- curative except for grade 1
36
Q

prognosis of brain tumor

A

5 year survival rate is 12 %

37
Q

treatment - ( HIGH GRADE GLIOMA)

A
  • Steroids – reduce oedema
  • Surgery – biopsy or resection
  • For tissue diagnosis, relief of raised ICP, prolongation of survival
  • Radiotherapy – mainstay of treatment.
  • Radical vs palliative
  • Chemotherapy – Temozolamide, PCV
38
Q

Treatment for low grade gliomas

A
  • Surgery – early resection
  • Radiotherapy and early chemotherapy = improves overall survival time from 7.8 years to 13.3 years
39
Q

Frontal lobe tumor may result in

A
  • movement
  • problem solving
  • ## behavior or personality change
40
Q

monroe kellie doctrine

A

The Monro-Kellie doctrine or hypothesis states that the sum of volumes of brain, cerebrospinal fluid (CSF) and intracerebral blood is constant. An increase in one should cause a reciprocal decrease in either one or both of the remaining two

Neuro (19 decks)

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