brain tumours Flashcards
general location of tumours in adults vs children
children = infratentorial adults = supratentorial (as adults are taller than children)
main risk factor for brain tumours
radiation exposure
which type of tumours are NF 1 and NF 2 associated with
NF 1 = optic nerve gliomas and schwannomas
NF 2 = bilateral schwannomas
which type of tumour is tuberous sclerosis associated with
subependymal giant cell astrocytomas
tumours which are features of Von-Hippel-Lindau disease?
renal tumours
pheochromocytoma
cerebellar and retinal hemangioblastomas
typical symptoms of brain tumour
headache
focal neurological deficits (eg: CN palsies or seizures)
neurocognitive disturbance
psychiatric symptoms (Eg: depression)
describe the characteristics of headache in brain tumours
dull, slowly progressive and poorly localised, involving the whole head
usually worse in the morning or during change in position, coughing etc as increases ICP
what is a complication of infratentorial tumours
obstructive hyrocephalus as interrupts CSF flow
symptom if Broca’s vs Wernicke’s are is involved
Broca's = expressive aphasia (know what want to say but struggle to say it) Wernicke's = receptive aphasia (hear the voice/see writing but cannot make sense of the words)
vestibular schwannomas cause which symptoms
sensorineural hearing loss and tinnitus (as CN VII)
pituitary tummours compressing optic chiasm causes
bitemporal hemiopia
Parinaud syndrome (from tumour compressing dorsal midbrain - below pineal gland)
upward gaze
pupillary light near dissociation (pupils react to near objects but not to light)
convergence retraction nystagmus
Cushing’s triad and what suggests
Triad = HTN, bradycardia and irregular breathing pattern suggests increased ICP
calcifications are seen on CT in which tumours (2)
oligodendrogliomas, craniopharyngiomas
contrast for imaging can penetrate BBB - T or F and why
Flase: normally UNABLE to cross BBB, so if contrast enhancement = tumour has broken down the barrier and leaded in
grade 4 glioma other name?
glioblastoma multiforme
glioblastoma classic appearance on imaging
rim enhancing lesion (centre doesn’t enhance as made of necrotic cells)
butterfly tumour
glioblastoma (as crosses corpus callosum between hemispheres)
special subtype of glioma which occurs in children
pilocytic astrocytoma - surgery = curative
meningiomas - benign or malignant
benign
how do vestibular schwannomas/acoustic neuromas present on MRI
homogeneously enhancing masses at cerebellopontine angle on MRI
hemangioblastoma appearance on MRI
bright, contrast enhancing nodule surrounded by a black, cystic component
key points about astrocytomas (6)
glioma from astrocyte
malignant
4 grades
grade 1 = slow growing over years
IV = kills in months (glioblastoma multiforme)
cytstic astrocytomas in children = relatively benign and cerebellar
key points about oligodendrogliomas (4)
malignant
from oligodendrocytes
slow growing
calcification common
benign brain tumours
meningioma
neurofibroma
primary malignant brain tumour of neuroepithelial tissue
astrocytoma oligodendroglioma ependymoma lymphoma medulloblastoma
common primary for brain tumour (metastatic)
bronchus breast stomach prostate thyroid kidney (BBKPST)
meningioma pathophysiology
arises from meninges and can grow to compress brain
neurofibromas (schwannomas) where originate from and usual location
from schwann cells
cerebellopontine angle from the VIITH nerve sheath (acoustic neuroma)
