Brain Tumours Flashcards
What is a vestibular schwannoma
Benign, slow-growing tumour of the Schwann cells that surround the Vestibulocochlear nerve
Where specifically do vestibular schwannoma often occur
Cerebellopontine angle
What genetic condition is associated with the development of bilateral vestibular schwannomas
Neurofibromatosis type 2 (auto dom)
Describe the common presentation of a vestibular schwannoma
- Asymmetrical sensorineural hearing loss
- Dizziness/ imbalance (particularly with quick head turning)
- absent corneal reflex
- unilateral Tinnitus
- Difficult localising sounds
Give 5 late findings of a vestibular schwannoma that imply a large tumour
- Nystagmus on lateral gaze
- Coordination difficulties
- Facial nerve palsy - weakness/numbness
- Gait disturbances
- Raised ICP
What cranial nerves are affected in vestibular schwannomas
5, 7 and 8 (all pass closely to the cerebellopontine junction)
How are vestibular schwannomas investigated
- gadolinium-enhanced MRI head (cerebellopontine angle) scan - contrast-enhanced mass
- audiogram
How are vestibular schwannoma treated depending on their size
- Small (<1.5cm) and asymptomatic = observation
- Medium <3cm = focused radiation or surgery
- Large >3cm = surgery
What is a meningioma
predominantly benign, extrinsic tumours of the CNS, arising from the arachnoid cap cells of the meninges
(second mc primary brain tumour in adults)
Where are meningiomas typically located
next to the dura:
* falx cerebri, superior sagittal sinus, convexity or skull base
Describe the common presentation of a meningioma
- Headache
- Seizures
- Neuro deficit
Give 3 RFs for meningiomas
- FHx of brain tumours
- Neurofibromatosis 2
- Radiotherapy
How are meningiomas treated
- Observation if asymptomatic
- Surgical resection
- Salvage surgery if initial treatments fail
What are gliomas
Tumours of the glial cells in the brain or spinal cord; glial cells surround and support the neurones
Give the 3 main types of gliomas in increasing order of malignancy
- Ependymoma
- Oligodendroglioma
- Astrocytoma
What is the most common and aggressive type of astrocytoma
Glioblastoma
Give 3 risk factors for gliomas
- Male
- Ionising radiation
- Neurofibromatosis type 1
Describe the common presentation of a glioma (6)
- Altered mental state
- Headache worse with coughing
- Seizures
- Gait abnormality
- N/V
- Ataxia
How are gliomas treated
- Maximal safe resection if accessible
- postoperative chemo +/- radiotherapy
- dexamethasone to treat oedema
How are brain tumours diagnosed
- GS: T1 weighted MRI with gadolinium contrast
- CT head/ spine
- Audiogram/ visual field testing
What is the most common form of brain tumour
metastatic brain cancer
What are the most common sites of secondary brain tumours
- lung (most common)
- breast
- colorectal
- skin (namely melanoma)
- kidney
