Brain Tumours Flashcards
what are common primary types of brain tumour?
neuroepithelial tissue (glioma), meninges (meningioma), pituitary usually benign (adenoma)
what are the common secondary types of brain tumour?
commonest tumours that spread to the brain are renal cell carcinoma, lung carcinoma, breast carcinoma, malignant melanoma, GI tract
what is the general quantity of primary and secondary tumours in the brain?
primary are usually single and secondary are usually multiple
what are gliomas?
derives from astrocytes, graded 1-IV, grade IV is the most common and most aggressive
what are glioblastoma multiforme (GBM)?
the worst malignant tumour known and spreads tracking through white mater and CSF pathway but very rarely spread systemically
what are meningiomas?
slow-growing, extra-axial= growing outside the brain and compressing it from the outside, usually benign and arise from the arachnoid layer of the meninges, frequently occur along the falx, convexity or sphenoid bone and if completely removed usually cured
what are pituitary tumours?
most are adenoma, only 1% malignant, present with visual disturbance due to compression of the optical chiasm and can cause hormone imbalance
how do brain tumours present?
raised ICP due to the mass effect, focal neurological deficit, epileptic fits, CSF obstruction if near CSF pathways
what are the symptoms of raised ICP?
headache (typically early morning), nausea/vomiting (headache relieved after vomiting ), visual disturbance (dipolpia, blurred vision), somnolence, cognitive impairment and altered consciousness
what are the signs of raised ICP?
papilloedema, 6th nerve palsy, cognitive impairment, altered consciousness, 3rd nerve palsy
how are brain tumours diagnosed?
history and examination, think of sources of secondary tumours (CXR), CT, MRI and biopsy if in doubt
how is GBM treated?
complete surgical excision is impossible, biopsy or debunk only, medical= steroids, anticonvulsants, RT, CT
what are localised lesions?
space occupying lesions in head= tumours, bleeding and abscesses
what is the effect of intracranial SOL?
amount of tissue increases which raises the ICP causing internal shift (herniation) between the intracranial spaces- left-right or right-left shifts, cerebrum moves inferiorly over edge of tentorium (uncle herniation) and cerebellum moves inferiorly into foramen magnum (coning)
what does swelling and shift cause?
localised ischaemia which tumours squeeze nearby tissue and cause local ischaemia
