Brain Tumours Flashcards
What is the most common extra-axial tumour?
meningioma
What are the most common presentation symptoms with brain tumours?
progressive neuro deficit-usually motor; headache; seizures
What are the features of a brain tumour headache ?
worse in the morning; wakes them up; increases with coughing and leaning forward; associated with vomiting
What is the cause of headache with a brain tumour?
raised ICP; invasion/compression of dura, periosteum; 2ry to diplopia or difficult focusing; extreme HT; psychogenic
What CN palsy do you get with a transtentorial hernation?
CNIII
What is the most common brain tumour?
astrocytoma
What does the presence of necrosis in an astrocytic tumour mean in terms of grading?
grade IV- GBM
Who gets pliocytomas?
children and young adults
What is the tx for pliocytomas?
surgery-curative
Where do grade 2 astrocytomas tend to appear?
temporal lobe; posterior frontal and anterior parietal
What is the typical presentation of low grade astrocytomas?
seizures
Why can low grade astrocytomas not be considered benign?
will transform into malignant over time
What are the signs of poor progrnosis of low grade astrocytoma?
age >45; low performance score; large tumour/crossing midline; incomplete resection
What is the treatment for low grade atrocytomas?
surgery plus chemo and radio
Where do GBMs tend to spread?
white metter/ CSF pathways
What is the function of surgery in GBM?
reduce mass effect- survivial quality rather curative
What are the driving implications for GBM?
not safe to drive as seizure risk
What are the SE of radiotherapy in brain tumours?
drops IQ by 10; tiredness; skin and hair
Where are oligodendroglial tumours typically found?
frontal lobes
who gets oligodendroglial tumours?
adults 25-45
How can oligodendroglial tumours be distinguished from astrocytomas?
have peripheral calcification; cysts and peritumoural haemorrhages
What is the tx for oligodendroglial tumours?
surgery + chemo and radio
What symptoms are seen in children with brain tumours?
tiptoeing; ataxia; vomiting with HA
What other conditions are associated with meningiomas?
breast cancer and NFII; radiation induced- eg after childhood leukaemia
What is the gender ratio for meningioma?
M:F 2:3
What are the symptoms of meningioma?
often asymptomatic; HA; CN neuropathies if at skull base
What is seen on imaging with meningiomas?
CT- homogenous, densely enhacnign; oedema; hyperostosis
MRI- dural tail
Why is preoperative embolisation done with meningiomas?
usually quite vascular tumours so eases complete tumour resection by reducing op time and blood lsos
What are the symptoms of acoustic neuromas?
hearing loss; tinnitus and dysequilibrium
What are the complications of surgery with acoustic neuroma?
facial nerve palsy; loss of cornal reflex; nystagmus; abnormal eye movement
What tests should be done for all midline brain tumours in children?
ALP; HCG and LDH (germ cell tumours)
What is the most common CNS germ cell tumour?
germinomas
What is the treatment for prolactinomas?
cabergoline
What is the treatment for GH secreting tumours?
surgey and somatostatin analogues
