Brain tumours Flashcards
Most common types of brain tumours?
Neuroepithelial tumours (gliomas). Of these, astrocytoma= most common
What do you look out for in suspected brain tumours?
- Pt acting strangely: personality changes
- headache
- visual disturbances
Which CN is a good indicator of raised ICP?
CN6 (Abducens)- can be compressed at many sites.
Assess visual fields and confrontation
Hx shows raised ICP with focal neuro deficits suggesting intracranial mass… what are your DDx?
- 1’ brain tumour
- Brain mets
- Brain abscess
- Chronic subdural haematoma
- Stroke→ unlikely though given time course + headache
- Migraine→ unlikely given time course, deficits and characteristics of headache
What is glioblastoma multiforme?
Form of malignant astrocytoma
How do pts with intracranial mass present?
- Symptoms of raised ICP (headache, N+V, drowsiness)
- Seizures (40-80%)
- Focal neuro deficits
o Depends on location of mass - Duration of symptoms depends on rate of growth of mass
Rx of malignant astrocytoma
1) Commence steroids
a. Dexamethasone
b. Reduction of cerebral oedema and ICP
2) Resection of as much of tumour as is safe
a. This is to reduce mass effect symptoms
b. Tissue Dx is essential
c. But resection often not possible due to extent of tumour, location or pt factors (age, fitness)
3) Adjuvant therapy
a. RadioRx and chemo
Main sources of brain mets
Lung, breast, melanoma
Rx for brain mets
- Rx o Start steroids (dexamethasone) • Reduce cerebral oedema and ICP o Surgery to remove mets if solitary • Can be used to identify what 1’ tumour is if we don’t know this • Can also be done in palliation to reduce disabling symptoms o Whole brain radiotherapy • Multiple mets o Chemo= poor penetration into the brain
Is meningioma malignant or benign?
Benign!
What cells does a meningioma arise from?
Arachnoid cells in meninges. Most common= falx
