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Neurology > Brain tumours > Flashcards

Brain tumours Flashcards

1
Q

Presentation of brain tumour

A 
Progressive neurological deficit
Usually motor weakness
Headache
Seizures
Vomiting
Mental changes
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2
Q

If you have a brain tumour, when is your headache worst? What aggravates it?

A

Worse in the morning (patient will wake up with it)

Worse when coughing/leaning forward (30%)

May be associated with vomiting

(OR symptoms similar to tension headache/migraine)

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3
Q

Most common extra-axial tumour

A

Meningioma

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4
Q

What is cushing’s triad?

A

Can occur because of increased ICP:

  • bradycardia
  • irregular respirations (impaired brainstem function)
  • widening pulse pressure

(widening pulse pressure is caused by increased difference between systolic and diastolic pressure over time)

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5
Q

DANISH

A 
dysdiadochokinesis
ataxia (cerebellar)
nystagmus
intention tremor
scanning dysarthria
heel-shin test
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6
Q

Dysarthria

A

Difficulty in articulating speech

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7
Q

Why might you need to do PET scan?

A

Can be used to locate primary tumour if metastases in the brain

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8
Q

What do radionucleotide studies show?

A

Can show abnormal tissue growths like tumour and can also show you how the organ is functioning

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9
Q

Where do pilocytic astrocytomas arise?

A

Optic nerve, hypothalamic gliomas

Cerebellum, brainstem

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10
Q

What age group affected by pilocytic astrocytomas?

A

Children, young adults

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11
Q

What are pilocytic astroytomas?

A

Low grade, usually benign tumours

Affect children and young adults

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12
Q

Treatment for pilocytic astrocytomas

A

Surgery

Curative

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13
Q

Most common type of low grade astrocytoma

A

Fibrillary astrocytoma

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14
Q

Low grade astrocytoma site predilication

A

Temporal lobe
Posterior frontal lobe
Anterior parietal lobe

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15
Q

Presentation of low grade astrocytomas

A

Seizures

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16
Q

Poor prognostic factors of low grade astrocytomas

A 
Age >50
Focal deficit  ( cf. seizures)
Short duration of symptoms
Raised ICP
Altered consciousness
Enhancement on contrast studies
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17
Q

What molecular profiles of grade II astrocytomas have a better prognosis?

A

IDH-1

1p19q

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18
Q

Treatment for grade II astrocytomas

A

Sugery +/- chemo/radio depending on molecular profile

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19
Q

Poor prognostic factors for a grade II gliomablastoma?

A

Poor prognosis:

  1. Age >45
  2. Low performance score
  3. Large tumors (dia. >6cm) / crossing midline
  4. Incomplete resection
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20
Q

Median survival if you have an anaplastic astrocytoma?

A

2 years

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21
Q

Median survival of glioblastoma multiforme?

A
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22
Q

How do glioblastoma multiformes spread?

A

White matter tracking/ CAF pathways

23
Q

Treatment for malignant astrocytomas (grade III/IV)

A

Non-curative surgery - focusses on survival quality

24
Q

In malignant astrocytomas, givine surgery PLUS radiotherapy PLUS chemo improves survival by how much?

A

14 months

25
Q

Importance of MGMT methylated tumour?

A

Live longer

26
Q

Side effects of radiotherapy

A

Drops IQ by ten
Skin and hair affected
Tired

27
Q

Age group affected by oligodendroglial tumours

A

25-45

28
Q

Which lobes affected in oligodendroglial tumours

A

Frontal lobes

29
Q

How could you differentiate oligodendeoglial tumours from astrocytomas?

A

Oligodendroglial tumours often:

  • calcification (peripheral)
  • cysts
  • peritumoral haemorrhage
30
Q

What treatment is really good for oligodendroglial tumours?

A

They are chemosensitive !!!

31
Q

Median survival for low grade oligodendroglial tumour?

A

Median survival 10 years at diagnosis

32
Q

This tumour arises from arachnoid cap cells

A

Meningioma

33
Q

This type of tumour is associated with breast cancer and NF II

A

Meningioma

34
Q

Meningiomas are associated with which other conditions?

A

Breast cancer

NF II

35
Q

Which conditions could give rise to multiple glioblastoma multiformes?

A

NF
TS
PML

36
Q

What type of brain tumour could be caused by radiotherapy?

A

Meningioma

37
Q

When do you give radiotherapy for meningiomas?

A

If incompletely excised or grade II/III

38
Q

Radiological description of meningiomas?

A
  • homogenous, densely enhancing
  • may display “dural tail”
  • hyperostosis / “skull blistering”
39
Q

Dural tail

A

Meningioma

40
Q

Skull blistering/ hyperostosis

A

Meningioma

41
Q

Meningiomas are quite vascular, what procedure might ease tumour resection?

A

Embolisation (pre-operative)

42
Q

NF II is associated with which type of tumour?

A

Vestibular schwannoma (of 8th nerve)

43
Q

How do acoustic neuromas present?

A

Hearing loss
Tinnitus
Loss of balance

44
Q

Why can acoustic neuromas cause hydrocephalus?

A

Interfere with CSF circulation

45
Q

Treatment of acoustic neuroma

A

Expectant
Hydrocephalus management
Radiation
Surgery

46
Q

Radiosurgery for acoustic neuroma

A

Gamma knife (usually if

47
Q

Most common CNS germ cell tumour

A

Germinomas

48
Q

Treatment for germinomas

A

RADIOSENSITIVE

49
Q

Age group affected by germ cell tumours?

A

Peak incidence 10-12 years

90% affect those younger than 20

50
Q

CT appearance of germ cell tumours

A

Iso or Hyperdense

51
Q

How may germ cell tumours metastasise?

A

Via the CSF

52
Q

AFP

A

Yolk sac tumours

and teratoma

53
Q

beta-HCG

A

Choriocarcinoma

and germinoma

54
Q

PLAP

A

germinoma

and chorciocarcinoma, yolk sac

Neurology (56 decks)

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