Brain Tumours Flashcards
What is the presentation of brain tumours?
May be asymptomatic when sma;; b
As they grow they present with focal neurological symptoms depending on location
Signs of raised ICP
In patients with headaches, what are concerning features that may indicate intracranial hypertension?
Constant headache
Nocturnal (occurring at night)
Worse on waking
Worse on coughing, straining or bending forward
Vomiting
Papilloedema on fundoscopy
What are other features of raised intracranial hypertension?
Altered mental state
Visual field defects
Seizures (particularly partial seizures)
Unilateral ptosis (drooping upper eyelid)
Third and sixth nerve palsies
What is papilloedema?
Describes swelling of the optic disc, secondary to raised ICP
What are gliomas?
Tumours of the glial cell in the brain or spinal cord
What do glial cells do?
Surround and support the neurones
What do glial cells include?
Asterocytes
Oligodendrocytes
Ependymal cells
How are gliomas graded?
1-4
What are the three main types of gliomas from most to least malignant?
Astrocytoma
Oligodendroglioma
Ependymoma
What are meningiomas?
Tumours growing from the cells of the meninges
Usually benign
How can meningioms cause affect?
They take up space and leads to raised ICP and neurological symptoms
What cancers can spread to the brain?
Lung
Breast
Renal cell carcinoma
Melanoma
What can pituatary tumours cause?
Bitemporal hemianopia
Hormone deficiencies
Excess hormones
What else c
What condition can pituatary tumours cause?
Acromegaly
Hyperprolatinaemia
Cushings disease
Thyrotoxicosis
How can pituatary tumours be managed?
Trans-sphenoidal surgery (through the nose and sphenoid bone)
Radiotherapy
Bromocriptine to block excess prolactin
Somatostatin analogues (e.g., octreotide) to block excess growth hormone
What are acoustic neuroma?
Benign tumours of the Schwann cells that surround the auditory nerve
What is the typical presentation for an acoustic neuroma?
40-60 yo
Unilateral sensorineural hearing loss
Unilateral tinnitus
Dizziness and imbalance
Sensations of fullness in the ear
Facial nerve palsy
What is the management of acoustic neuroma?
Conservative if there are no symptoms
Surgery
Radiotherapy
What is the first line investigation in brain tumours?
MRI scan
What other investigation should be done?
Biopsy which gives the definitive histological diagnosis
What does management depend on?
Type and grade
What are the main management options?
Surgery
Chemotherapy
Radiotherapy
Palliative care
