brain tumours

Question 1

general location of tumours in adults vs children

Answer 1

children = infratentorial
adults = supratentorial (as adults are taller than children)

Question 2

main risk factor for brain tumours

Answer 2

radiation exposure

Question 3

which type of tumours are NF 1 and NF 2 associated with

Answer 3

NF 1 = optic nerve gliomas and schwannomas

NF 2 = bilateral schwannomas

Question 4

which type of tumour is tuberous sclerosis associated with

Answer 4

subependymal giant cell astrocytomas

Question 5

tumours which are features of Von-Hippel-Lindau disease?

Answer 5

renal tumours
pheochromocytoma
cerebellar and retinal hemangioblastomas

Question 6

typical symptoms of brain tumour

Answer 6

headache
focal neurological deficits (eg: CN palsies or seizures)
neurocognitive disturbance
psychiatric symptoms (Eg: depression)

Question 7

describe the characteristics of headache in brain tumours

Answer 7

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

Question 8

what is a complication of infratentorial tumours

Answer 8

obstructive hyrocephalus as interrupts CSF flow

Question 9

symptom if Broca’s vs Wernicke’s are is involved

Answer 9

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)

Question 10

vestibular schwannomas cause which symptoms

Answer 10

sensorineural hearing loss and tinnitus (as CN VII)

Question 11

pituitary tummours compressing optic chiasm causes

Answer 11

bitemporal hemiopia

Question 12

Parinaud syndrome (from tumour compressing dorsal midbrain - below pineal gland)

Answer 12

upward gaze
pupillary light near dissociation (pupils react to near objects but not to light)
convergence retraction nystagmus

Question 13

Cushing’s triad and what suggests

Answer 13

Triad = HTN, bradycardia and irregular breathing pattern suggests increased ICP

Question 14

calcifications are seen on CT in which tumours (2)

Answer 14

oligodendrogliomas, craniopharyngiomas

Question 15

contrast for imaging can penetrate BBB - T or F and why

Answer 15

Flase: normally UNABLE to cross BBB, so if contrast enhancement = tumour has broken down the barrier and leaded in

Question 16

grade 4 glioma other name?

Answer 16

glioblastoma multiforme

Question 17

glioblastoma classic appearance on imaging

Answer 17

rim enhancing lesion (centre doesn’t enhance as made of necrotic cells)

Question 18

butterfly tumour

Answer 18

glioblastoma (as crosses corpus callosum between hemispheres)

Question 19

special subtype of glioma which occurs in children

Answer 19

pilocytic astrocytoma - surgery = curative

Question 20

meningiomas - benign or malignant

Answer 20

benign

Question 21

how do vestibular schwannomas/acoustic neuromas present on MRI

Answer 21

homogeneously enhancing masses at cerebellopontine angle on MRI

Question 22

hemangioblastoma appearance on MRI

Answer 22

bright, contrast enhancing nodule surrounded by a black, cystic component

Question 23

key points about astrocytomas (6)

Answer 23

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

Question 24

key points about oligodendrogliomas (4)

Answer 24

malignant
from oligodendrocytes
slow growing
calcification common

Question 25

benign brain tumours

Answer 25

meningioma

neurofibroma

Question 26

primary malignant brain tumour of neuroepithelial tissue

Answer 26

astrocytoma
oligodendroglioma
ependymoma
lymphoma
medulloblastoma

Question 27

common primary for brain tumour (metastatic)

Answer 27

bronchus
breast
stomach
prostate
thyroid
kidney 
(BBKPST)

Question 28

meningioma pathophysiology

Answer 28

arises from meninges and can grow to compress brain

Question 29

neurofibromas (schwannomas) where originate from and usual location

Answer 29

from schwann cells

cerebellopontine angle from the VIITH nerve sheath (acoustic neuroma)