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Neurology > Brain tumours > Flashcards

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
Q

What disease is bilateral acoustic neuroma associated with?

A

NF2

26
Q

Who is most at risk of acoustic neuroma?

A

Those age 40-60

27
Q

How does acoustic neuroma present?

A
  • Unilateral sensorineural hearing loss(often the first symptom)
  • Unilateral tinnitus
  • Dizzinessorimbalance
  • Sensationoffullnessin the ear
  • Facial nerve palsy(if the tumour grows large enough to compress the facial nerve)
28
Q

How may acoustic neuroma be managed?

A
  • Conservative
  • Surgery
  • Radiotherapy
29
Q

What is a medulloblastoma?

A

A common, malignant tumour of children, arising from the cerebellar stem cells, which seeds in the CSF pathways

30
Q

What are some symptoms of medulloblastoma?

A

Hydrocephalus
Cerebellar signs (DANISH)
Mass effect symptoms
Extra-ocular muscle palsy

31
Q

What investigations are required to diagnose medulloblastoma?

A

Lumbar puncture
MRI
CT head and spine

32
Q

How may medulloblastoma be managed?

A
  • Surgery
  • Radiotherapy
  • Chemotherapy
33
Q

What are some global symptoms of brain tumours?

A
  • Headache
  • Nausea and vomiting
  • Reduced GCS
  • Pupillary defect
34
Q

What are some focal symptoms of brain tumours?

A
  • Paresis
  • Dysphasia
  • Numbness
  • Seizure
  • Visual symptoms
  • Dyscoordination
  • Motor weakness
35
Q

Describe a typical brain tumour headache

A

Worse in the morning (May wake them up)
Worse with coughing and leaning forward
associated with vomiting
Symptoms of migraine

36
Q

What are the 5 points of performance scoring (PS)?

A
  • 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
Q

What are the most common tumours that metastasise to the brain?

A

Lung
Breast
Skin (Melanoma)
Kidney

38
Q

How is cerebral oedema surrounding a tumour managed?

A

Steroid therapy

39
Q

Management options for brain tumours

A

Neurosurgical resection
Stereotactic radiotherapy
Whole-brain radiotherapy
Chemotherapy (Palliative)

40
Q
A

Neurology (28 decks)

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