Brain Tumors

Question 1

What are the 2 classifications of brain tumors?

Answer 1

Primary - originate in CNS

Secondary - Spread to CNS from systemic cancer site outside the brain

Question 2

What are the most common primary brain tumors?

Answer 2

Gliomas

Primary tumor arise from supportive tissues of the brain

Question 3

What are the 4 primary categories of gliomas?

Answer 3

Astrocytomas (most common)
Oligodendrogliomas
Ependymomas
Medulloblastomas

Question 4

Where do astrocytomas typically originate?

Answer 4

Cerebrum originated in frontal lobe in adults

Cerebellum in children

Question 5

Describe Glioblastoma multiforme.

Answer 5

Highly malignant grade IV astrocytoma
Grow rapidly
Located in deep white matter
Most common in older adults, uncommon in children
<33% survive more than a year

Question 6

Describe Oligodendrogliomas.

Answer 6

Slow-growing but progressive
50% involve multiple lobes
Many clients have seizures as only clinical manifestation
Typically appear in 4th to 6th decade of life

Question 7

What are Ependymomas and Ependymoblastomas?

Answer 7

Tumors arising from cells that line the ventricles of the brain and central canal of spinal cord
Grow into ventricle
Frequently recur

Question 8

What is common with medulloblastomas?

Answer 8

Primary occur in children (20% of brain tumors in kids)

Typically grow into 4th ventricle blocking CSF flow (hydrocephalus)

Question 9

What are some other common brain tumors?

Answer 9

Meningioma - slow growing, account for 33% of brain tumors (incidentally discovered during imaging)
Pituitary Adenomas
Schwannomas

Question 10

How many people with systemic cancer develop metastatic brain tumors?

Answer 10

25%

1/3 of brain metastases originate in lung followed by breasts

Question 11

What are some signs and symptoms of a brain tumor? (5)

Answer 11

Headaches (present in 30%, develop in 70%)
Seizures (1/3 of cases)
Nonspecific cognitive or personality changes
Focal neurological signs
Papilledema

Question 12

How are brain tumors managed?

Answer 12

Surgery
Chemotherapy
Radiation Therapy
Stereotactic radio surgery

Question 13

What are goals for rehab during PT?

Answer 13

Prevent complications
Maximize function
Provide support
All to improve quality of life

Question 14

How should you set goals for treatment?

Answer 14

Goals should maximize potential for function
Introduce effective, task-oriented movement strategies
Offer multiple movement options and ongoing exercise routine

Question 15

Name some common outcome measures you can use.

Answer 15

FIM
Health-related Quality of Life
Functions Living Index
Karnofsky Performance Scale
Index of Independence in ADLS