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Brain tumours Flashcards

1
Q

What are some conditions that can increase risk of brain tumours

A

NF
VHL
Tuberose sclerosis
Li-Fraumeni syndrome

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2
Q

What causes headache in brain tumour?

A
  • Raised ICP
  • Invasion/compression of dura, BVs or periosteum
  • Secondary to diplopia (CN III, IV,VI; INO)
  • Secondary to difficulty focusing
  • Extreme hypertension
  • Psychogenic (stress of loss of functional capacity)
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3
Q

Neurological signs of anterior frontal lobe tumours

A

Conscious though, reasoning, behaviour and memory impairment

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4
Q

Neurological signs of inferior frontal lobe tumours

A

Smell dysfunction

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5
Q

Neurological signs of pre-central gyrus tumour

A

Movement dysfunction (related to homunculus)

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6
Q

Neurological signs of post-central gyrus tumour

A

Sensory dysfunction (Related to homunculus)

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7
Q

Neurological signs of anterior temporal lobe tumours

A

Behaviour, memory, hearing, vision and emotional dysfunction

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8
Q

Neurological signs of left posterior temporal lobe tumours?

A

Speech, motor and sensory dysfunction

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9
Q

Neurological signs of right posterior temporal lobe tumours?

A

Dysfuction in abstract concept understanding

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10
Q

DANISH signs of cerebellar disease

A

D - Dysdiadochokinesia
A - Ataxia
N - Nystagmus
I - Intention tremor
S - Slurred speech
H - Hypotonia

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11
Q

Neurological signs of occipital lobe tumour

A

Vision defects

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12
Q

Forms of high-grade brain tumours

A
  • Gliomas and glioblastoma multiforme
  • Primary cerebral lymphomas
  • Medulloblastomas
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13
Q

Forms of low-grade brain tumours

A
  • Meningiomas
  • Acoustic neuromas
  • Pituiary tumours
  • Pineal tumours
  • Craniopharyngiomas
  • Neurofibromas
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14
Q

What is a glioma

A

A tumour of the glial cells of the brain or spinal cord

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15
Q

How many grades of glioma are there?

A

4
1 is the most benign, 4 is the most malignant

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16
Q

Pilocytic astrocytoma is a grade … glioma

A

1 (>10 year survival)

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17
Q

Low grade glioma is a grade … glioma

A

2 (10-12 year survival)

18
Q

Anapaestic astrocytoma is a grade … glioma

A

3 (2-5 year survival)

19
Q

Glioblastoma multiforme is a grade … glioma

A

4 (12-18 month survival)

20
Q

What are meningiomas?

A

Tumours arising from the cells of the meninges surrounding the brain and spinal cord

21
Q

How do meningiomas cause problems?

A

They are usually benign but cause problems via mass effect

22
Q

What is an acoustic neuroma?

A

A benign tumour of the schwann cells surrounding the auditory (Vestibulocochlear) nerve

23
Q

What is another term for acoustic neuroma?

A

Vestibular schwannoma

24
Q

Where do acoustic neuromas usually occur?

A

Unilaterally at the cerebellopontine angle

25
What disease is bilateral acoustic neuroma associated with?
NF2
26
Who is most at risk of acoustic neuroma?
Those age 40-60
27
How does acoustic neuroma present?
- Unilateral sensorineural hearing loss (often the first symptom) - Unilateral tinnitus - Dizziness or imbalance - Sensation of fullness in the ear - Facial nerve palsy (if the tumour grows large enough to compress the facial nerve)
28
How may acoustic neuroma be managed?
- Conservative - Surgery - Radiotherapy
29
What is a medulloblastoma?
A common, malignant tumour of children, arising from the cerebellar stem cells, which seeds in the CSF pathways
30
What are some symptoms of medulloblastoma?
Hydrocephalus Cerebellar signs (DANISH) Mass effect symptoms Extra-ocular muscle palsy
31
What investigations are required to diagnose medulloblastoma?
Lumbar puncture MRI CT head and spine
32
How may medulloblastoma be managed?
- Surgery - Radiotherapy - Chemotherapy
33
What are some global symptoms of brain tumours?
- Headache - Nausea and vomiting - Reduced GCS - Pupillary defect
34
What are some focal symptoms of brain tumours?
- Paresis - Dysphasia - Numbness - Seizure - Visual symptoms - Dyscoordination - Motor weakness
35
Describe a typical brain tumour headache
Worse in the morning (May wake them up) Worse with coughing and leaning forward associated with vomiting Symptoms of migraine
36
What are the 5 points of performance scoring (PS)?
- 0 - Normal activity - 1 - Symptomatic and ambulatory, cares for self - 2 - Ambulatory >50% of the time, occasional assistance - 3 - Ambulatory ≤50% of the time, nursing care needed - 4 - Bedridden
37
What are the most common tumours that metastasise to the brain?
Lung Breast Skin (Melanoma) Kidney
38
How is cerebral oedema surrounding a tumour managed?
Steroid therapy
39
Management options for brain tumours
Neurosurgical resection Stereotactic radiotherapy Whole-brain radiotherapy Chemotherapy (Palliative)
40

Neurology (28 decks)

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