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6. Neurology (Med) > Brain Tumours > Flashcards

Brain Tumours Flashcards

1
Q

What are examples of CNS tumours?

A
  • Tumours of neuroepitheal tissue
  • Tumours of meninges
  • Tumours of cranial and spinal nerves
  • Haematopoitic neoplasms
  • Germ cell tumours
  • Cysts and tumour like lesions
  • Tumours of the sellar region
  • Local extensions from regional tumours
  • Metastatic tumours
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2
Q

What are some common primary brain tumours?

A
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3
Q

What are some common secondary brain tumours?

A

Renal cell carcnoma

Lung carcinoma

Breast carcinoma

Malignant melanoma

GI tract

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4
Q

What is the most common brain tumour seen clinically?

A

Metastases

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5
Q

What are gliomas?

A

Cancer of astrocytes

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6
Q

What is the function of astrocytes?

A

Astrocytes give structural and nutritional support to nerve cells

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7
Q

How are gliomas staged?

A

WHO grades from I to IV, with IV being the most common:

  • Most aggressive
  • Glioblastoma multiforme (GBM)
  • Spread by tracking through white mater and CSF pathway
  • Very rarely spread systematically
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8
Q

What are meningiomas?

A

Cancer of meninges

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9
Q

What are the characteristics of meningiomas?

A
  • Slow growing
  • Extra-axial
  • Usually benign
  • Arise from arachnoid
  • Frequently occur along falx, convexity or sphenoid bone
  • Usually cured if completely removed
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10
Q

Are meningiomas slow or fast growing?

A

Slow growing

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11
Q

Are meningiomas usually benign or malignant?

A

Benign

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12
Q

What do meningiomas arise from?

A

Arachnoid tissue

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13
Q

What is the most common pituitary tumour?

A

Adenoma

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14
Q

Are pituitary tumours usually benign or malignant?

A

Benign, only 1% are malignant

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15
Q

What is the clinical presentation of pituitary tumours?

A
  • Visual disturbance
    • Due to compression of optic chiasm
  • Hormone imbalance
  • Raised ICP
    • Mass effect
  • Focal neurological deficit
  • Epileptic fits
  • CSF obstruction
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16
Q

What are symptoms of raised ICP?

A
  • Headache
    • Typically morning headache
  • Nausea/vomiting
  • Visual disturbance
    • Diplopia
  • Somnolence
  • Cognitive impairment
  • Altered consciousness
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17
Q

When does the headache due to raised ICP usually occur?

A

Morning

18
Q

What are signs of raised ICP?

A
  • Papilleodema
  • 6th nerve palsy
  • Cognitive impairment
  • Altered consciousness
  • 3rd nerve palsy
19
Q

What is the typical CSF production in a day?

A

400-450cc

20
Q

What is hydrocephalus caused by?

A

Caused by tumours in or close to CSF pathways, especially posterior fossa tumours (pituitary)

21
Q

What is done to diagnose hydrocephalus?

A
  • History and examination
  • Think sources of secondary tumours (such as chest x-ray)
  • CT scan
  • MRI scan
  • Biopsy
22
Q

What is focal neurological deficit?

A

Problem with nerve, spinal cord, or brain function, affecting a specific location such as part of tongue or side of face

23
Q

What is the clinical presentation of focal neurological deficit?

A
  • Hemiparesis
  • Dysphagia
  • Hemianopia
  • Cognitive impairment (memory, sense of direction)
  • Cranial nerve palsy
  • Endocrine disorders
24
Q

What is hemianopia?

A

Blindness over half the field of vision

25
Q

What is ataxia?

A

Term for group of disorders that affect co-ordination, balance and speech

26
Q

What does in-coordination mean?

A

Harmonious functioning of parts for effective results

27
Q

What is the medical term for loss of ability to perform simple calculations?

A

Acalculia

28
Q

What is the medical term for loss of ability to communicate through writing?

A

Agraphia

29
Q

What is the medical term for inability to interpret sensations and hence recognise things?

A

Agosia

30
Q

What are the 2 kinds of epilepsy?

A
  • Focal epilepsy
  • Generalised epilepsy
31
Q

Epilepsy only occurs in lesions above where>?

A

Tentorium

32
Q

What investigations are done for brain tumours?

A

Adequate cerebral imaging:

  • CT
  • MRI
  • PET
  • Angiography

If suspected metastases:

  • CT chest/abdomen/pelvis
  • Mammography
  • Biopsy skin lesions/lymph nodes
33
Q

What are the managent goals for a brain tumour?

A
  • Accurate tissue diagnosis
  • Improve quality of life
    • Decreasing mass effect
    • Improve neurological deficit
  • Aid effect of adjuvant therapy
  • Prolong life expectancy
34
Q

What does the management of a brain tumour involve?

A
  • Corticosteroids
    • Dexamethasone
  • Treat epilepsy
    • Anticonvulsant drugs
  • Analgesics/antimetics
  • Counselling
  • Surgery
  • Radiotherapy
  • Chemotherapy
  • Endocrine replacement
35
Q

What are the management options for a brain tumour?

A
36
Q

What is the prognosis of meningioma?

A
  • Commonly cured by surgery, may required anticonvulsants
37
Q

What is the prognosis of low grade astrocytomas?

A

Long life expectancy

38
Q

What is the prognosis of high grade astrocytoma/GBM?

A

Average 1 year survival

39
Q

What is the prognosis of metastases in the brain?

A
  • Frequently good medium term remission
40
Q

When should a LP never be performed?

A

Remember, DO NOT perform a lumbar puncture when there are signs and symptoms to suggest an intracranial mass lesion, this is because you might:

  • Cause meningitis
  • Cause a herniation syndrome and the patient could die
  • Cause an air embolism
  • Make the patient’s headache worse
41
Q

Why should a lumbar puncture never be performed when there are signs/symptoms to suggest an intracranial mass lesion?

A

Because you might:

  • Cause meningitis
  • Cause a herniation syndrome and the patient could die
  • Cause an air embolism
  • Make the patient’s headache worse

6. Neurology (Med) (47 decks)

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