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Charis & Ellie VS Neuro > Brain Tumours > Flashcards

Brain Tumours Flashcards

1
Q

Which instance is higher primary brain tumours or metastatic?

A

Metastatic neoplasms

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2
Q

Appearance of metastatic brain tumours?

A

Multiple, well-delineated spherical nodules that are randomly distributed

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3
Q

2 most common primary sites for malignant brain tumours to arise from?

A

Breast
Lung
But any malignant tumour can metastasise to there

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4
Q

Difference between primary brain tumours and epithelial tumours?

A

Isn’t always a distinct cut off for benign and malignant in primary. There is in epithelial.

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5
Q

What are gliomas?

A

Tumours of the neuroepithelial (neuroepithelial origin)

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6
Q

Where do gliomas usually occur?

A

Usually seen within the hemispheres

-Although occasionaly in cerebellum, brainstem or cord

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7
Q

Cause of gliomas?

A

Unknown

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8
Q

How do gliomas spread?

A

By direct invasion

-Never metastases (virtually) outside the CNS

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9
Q

Main type of gliomas?

A

Astrocytomas and oligodendrogliomas

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10
Q

More rare types of gliomas?

A

Ependymal cell tumours
Pineal cell tumours
Embryonic cell tumours

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11
Q

What are astrocytomas?

A

Gliomas that arise from astrocytes

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12
Q

How are astrocytomas histologically graded?

A

Grade I-IV

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13
Q

Difference between grade I and grade IV astrocytomas?

A

Grade I: Grows very slowly over many years

Grade IV: Causes death within several months

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14
Q

Grade II astrocytomas?

A

Blurring between grey and white matter which makes them more difficult to dissect

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15
Q

Grade IV astrocytomas shows?

A

Marked abnormalities with haemorrhagic change, necrosis, loss of integrity of tissues and surrounding oedema
Causing midline shift

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16
Q

What are grade IV astrocytomas termed?

A

Glioblastomas/glioblastoma multiforme

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17
Q

Talk to me about glioblastoma multiforme?

Commonness (?), occurs, prognosis

A
  • Commonest glial tumour
  • May occur de novo or following history of low grade astrocytoma
  • Highly malignant
  • Prognosis of patients is v poor
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18
Q

What are gliomas that arise from dendrocytes called?

A

Oligodendroglioma

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19
Q

How oligodendrogliomas exist and what occurs to them?

A

Grow very slowly over several decades and calcification is common

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20
Q

What is the fancy name for childhood brian tumours?

A

Tumours of neuronal cell types

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21
Q

What can fully differentiated neurons not do?

A

Neither multiply or give rise to neoplasms

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22
Q

What type of tumours are seen in infancy or childhood?

Derived from?

A

Tumours of neuronal cell types

-Derived from primitive nerve precursors (blast cells)

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23
Q

What are blast cells?

A

Basically a precursor to mature neurons

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24
Q

What do you call a neuronal tumour arising from cerebellum?

A

Medulloblastoma

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25
Q

Retinoblastoma is?

A

Tumour arising from the retina

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26
Q

What are tumours which arise from sympathetic ganglia?

A

Neuroblastoma

Ganglioneuroma

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27
Q

Explain something interesting about ganglioneuromas?

A

Tumour is derived from blast cells but as the tumour grows the neurons actually mature

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28
Q

Tumours which arise in supporting tissue/mesodermal?

A

Meningiomas

Other mesodermal tumours

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29
Q

Where are meningiomas thought to arise from?

A

Arachnoid granulations

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30
Q

Where would you find meningiomas commonly?

A

Adjacent to venous tissues

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31
Q

________ account for 15-20% of intracranial tumours.

A

Meningiomas

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32
Q

Are meningiomas bad?

A

Slow-growing and essentially benign

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33
Q

Where can meningiomas occasionally arise?

A

Spine

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34
Q

True vascular neoplasms are_______, but vascular hamartomas are _________.

A
  1. Rare

2. Common

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35
Q

What is a hamartoma?

A

Noncancerous tumour made of an abnormal mixture of normal tissues and cells from the area in which it grows

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36
Q

Primary microglial and lymphoid tumours are common/rare?

A

Rare

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37
Q

What tumours are associated with EBV? And what does this make them?

A

Primary cerebral lymphomas

-Important complication of AIDs

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38
Q

Schwannoma AKA?

A

Neuroma

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39
Q

What are neuromas derived from?

A

Schwann cells surrounding axons

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40
Q

Most common neuroma?

A

Vestibular schwannoma (acoustic neuroma) which arises from CNVIII in the cerebellopontine angle

41
Q

Where do acoustic neuromas arise from?

A

CNVIII in the cerebellopontine angle

42
Q

Symptoms of vestibular schwannoma?

A

Progressive sensorineural hearing loss
Tinnitus
Vertigo

Tumour is often unilateral so symptoms are too

43
Q

What tumour commonly has unilateral symptoms?

A

Vestibular schwannoma/acoustic neuroma

44
Q

Prognosis of vestibular schwannoma?

A

Benign

  • Tend to grow around adjacent structures
  • Irregular surface so can be difficult to remove
45
Q

What are neurofibromas derived from?

A

Endoneurium

-Layer of delicate connective tissue around the myelin sheath of each nerve in the PNS

46
Q

Amount of neurofibromas common?

A

Can be solitary, or in neurofibromatosis multiple

47
Q

What sets neurofibromas apart from schwannomas?

A

Small but significant proportion of neurofibromas undergo transformation to malignant peripheral nerve sheath tumours

48
Q

Where and derivation of germ cell tumours?

A

Arise in midline structures

-Derived from embryologically misplaced germ cells

49
Q

Pituitary gland tumour example?

A

Adenoma

50
Q

What is a craniopharyngioma?

A

Rare type of brain tumour derived from pituitary gland embryonic tissue

51
Q

General knowledge for direct effects of brain tumours?

A

Local progressive deterioration in function, signs and symptoms will depend on area of brain affected

52
Q

Direct effects of frontal lobe lesions: Precentral gyrus?

A

-Contralateral weakness (part of the body where this occurs depends where tumour is in gyrus- corresponds with motor homunculus)

53
Q

Where is Broca’s area?

A

Inferior frontal gyrus

54
Q

Direct effects of frontal lobe lesions: Broca’s area?

A

-Expressive dysphasia where patent can still comprehend words but produces faulty sentences

55
Q

Dysphasia?

A

How you speak and understand languages
-People with dysphasia might have trouble putting the right words together in a sentence, understanding what others say, reading, and writing

56
Q

Direct effect of tumour in middle frontal gyrus?

A

Abnormalities of gaze

57
Q

Tumour in micturition inhibition centre causes?

A

Incontinence

58
Q

Frontal lobe lesions direct effects?

A

Personality changes, disinhibition and cognitive slowing

59
Q

Frontal lobe lesions examples?

A
  • Precentral gyrus
  • Broca’s area (Inferior frontal gyrus)
  • Frontal eye fields (Middle frontal gyrus)
  • Micturition inhibition centre
60
Q

Temporal lobe lesions exmaples?

A

Auditory cortex and wernickes area (superior temporal gyrus)

61
Q

Tumour in Auditory cortex can lead to?

A

Loss of awareness of sound

62
Q

Tumour in Wernicke’s area?

A

Damage can lead to receptive dysphagia in which an individual has impaired comprehension and produces jargon (word salad) but fluent speech

63
Q

Where is Wernicke’s area?

A

Located in superior temporal gyrus in dominant hemisphere

64
Q

General direct effects of temporal lobe lesions?

A

Memory deficits

Contralateral superior quadrantanopia

65
Q

Tumour in occipital lobe lesions causes?

A

Visual cortex: visual hallucinations

-Contralateral homonymous hemianopia

66
Q

Parietal lobe lesions: Postcentral gyrus cause?

A

Contralateral sensory loss

Part of body will depend on location along gyrus

67
Q

Parietal lobe lesions can cause?

A

Contralateral inferior quadrantopia

68
Q

If dominant lobe affected in parietal lobe lesions?

A
  • Dyscalculia
  • Dysgraphia (difficulty writing)
  • Finger agnosia (inability to distinguish between and recognise all fingers)
  • Left-right disorientation
69
Q

What is the dominant parietal lobe usually?

A

Left

70
Q

Non-dominant parietal lobe lesions causes?

A
  • Neglect
  • Dressing apraxia
  • Constructional apraxia
71
Q

What is neglect?

A

Deficit in awareness of one side of the body

72
Q

Dressing apraxia?

A

Inability to dress onseself automatically

73
Q

Constructional apraxia?

A

Inability to build, assemble or draw objects

74
Q

Cerebellum lesions memory tool?

A

DANISH

75
Q

DANISH?

A 
Dysdiadochokinesia 
Ataxia
Nystagmus 
Intention tremor 
Scanning dysarthria 
Hypotonia
76
Q

What is dysdiadochokinesia?

A

Impairment of rapid alternating movements: quick alternating, pronation supination of hand

77
Q

Ataxia?

A

Broad based gait

78
Q

Nystagmus?

A

Involuntary, uncontrolled eye movements

79
Q

Intention tremor?

A

Tremor that gets worse as you approach end point of guided movement, finger yo nose test can show this

80
Q

Scanning dysarthria?

A

Patient speaks slowly with poor articulation of speech

81
Q

Hypotonia?

A

Reduced tone

82
Q

Raised ICP due to mass lesion can present as?

A

Headache, vomiting and papilloedema

83
Q

Headache red flags pointing to a tumour?

A
  • Headache worse in morning
  • Headache that wakes you up
  • Headache worse with coughing or leaning forward
  • Headache assoc with vomiting
84
Q

Why is a red flag headache worse in morning?

A

Because lying down increases ICP

85
Q

Why would a headache be assoc with vomiting?

A

Pressure on medulla

86
Q

What is papilloedema and cause?

A

Bilateral optic disc swelling due to raised ICP

87
Q

Seizures are a common presenting feature of?

A

Malignant brain tumours

88
Q

Why seizure = malig brain tumour?

A

Tumour irritates cortex and disrupts normal electrical pathways

89
Q

Partial seizures evolving into generalized tonic clonic seizures are characteristic of?

A

Many hemisphere masses whether benign or malignant

90
Q

Investigation of choice for brain tumours?

A

MRI

however CT if MRI not available

91
Q

Other investigations whne brain tumour found?

A

Because they are usually mets a chest X-ray should be done

92
Q

Treatment of low grade astrocytomas?

A

Removed as it has been shown that these tumours if left have potential to de-differentiate into a high grade malignancy

93
Q

De-differntiate?

A

Reverse differentiation and lose specialised charcteristics

94
Q

Gold standard treatment for glioblastomas?

A

Surgery, radiotherapy and chemo

Although still poor prognosis

95
Q

Treatment for oligodendroglial tumours?

A

Mix of surgery, chemo, radio

96
Q

Treatment of meningiomas?

A

Small: watched
Large: Surgery and other

97
Q

Treatment of vestibular schwannomas?

A

Often not removed: surgery risks permenant hearing loss:

  • Watched
  • Hearing aid given
98
Q

Surgery for vestibular schwannomas difficult because?

A

Surface so irregular and grow around adjacent structures

Charis & Ellie VS Neuro (49 decks)

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