Brain Tumours

Question 1

What is the most common extra-axial tumour?

Answer 1

meningioma

Question 2

What are the most common presentation symptoms with brain tumours?

Answer 2

progressive neuro deficit-usually motor; headache; seizures

Question 3

What are the features of a brain tumour headache ?

Answer 3

worse in the morning; wakes them up; increases with coughing and leaning forward; associated with vomiting

Question 4

What is the cause of headache with a brain tumour?

Answer 4

raised ICP; invasion/compression of dura, periosteum; 2ry to diplopia or difficult focusing; extreme HT; psychogenic

Question 5

What CN palsy do you get with a transtentorial hernation?

Answer 5

CNIII

Question 6

What is the most common brain tumour?

Answer 6

astrocytoma

Question 7

What does the presence of necrosis in an astrocytic tumour mean in terms of grading?

Answer 7

grade IV- GBM

Question 8

Who gets pliocytomas?

Answer 8

children and young adults

Question 9

What is the tx for pliocytomas?

Answer 9

surgery-curative

Question 10

Where do grade 2 astrocytomas tend to appear?

Answer 10

temporal lobe; posterior frontal and anterior parietal

Question 11

What is the typical presentation of low grade astrocytomas?

Answer 11

seizures

Question 12

Why can low grade astrocytomas not be considered benign?

Answer 12

will transform into malignant over time

Question 13

What are the signs of poor progrnosis of low grade astrocytoma?

Answer 13

age >45; low performance score; large tumour/crossing midline; incomplete resection

Question 14

What is the treatment for low grade atrocytomas?

Answer 14

surgery plus chemo and radio

Question 15

Where do GBMs tend to spread?

Answer 15

white metter/ CSF pathways

Question 16

What is the function of surgery in GBM?

Answer 16

reduce mass effect- survivial quality rather curative

Question 17

What are the driving implications for GBM?

Answer 17

not safe to drive as seizure risk

Question 18

What are the SE of radiotherapy in brain tumours?

Answer 18

drops IQ by 10; tiredness; skin and hair

Question 19

Where are oligodendroglial tumours typically found?

Answer 19

frontal lobes

Question 20

who gets oligodendroglial tumours?

Answer 20

adults 25-45

Question 21

How can oligodendroglial tumours be distinguished from astrocytomas?

Answer 21

have peripheral calcification; cysts and peritumoural haemorrhages

Question 22

What is the tx for oligodendroglial tumours?

Answer 22

surgery + chemo and radio

Question 23

What symptoms are seen in children with brain tumours?

Answer 23

tiptoeing; ataxia; vomiting with HA

Question 24

What other conditions are associated with meningiomas?

Answer 24

breast cancer and NFII; radiation induced- eg after childhood leukaemia

Question 25

What is the gender ratio for meningioma?

Answer 25

M:F 2:3

Question 26

What are the symptoms of meningioma?

Answer 26

often asymptomatic; HA; CN neuropathies if at skull base

Question 27

What is seen on imaging with meningiomas?

Answer 27

CT- homogenous, densely enhacnign; oedema; hyperostosis

MRI- dural tail

Question 28

Why is preoperative embolisation done with meningiomas?

Answer 28

usually quite vascular tumours so eases complete tumour resection by reducing op time and blood lsos

Question 29

What are the symptoms of acoustic neuromas?

Answer 29

hearing loss; tinnitus and dysequilibrium

Question 30

What are the complications of surgery with acoustic neuroma?

Answer 30

facial nerve palsy; loss of cornal reflex; nystagmus; abnormal eye movement

Question 31

What tests should be done for all midline brain tumours in children?

Answer 31

ALP; HCG and LDH (germ cell tumours)

Question 32

What is the most common CNS germ cell tumour?

Answer 32

germinomas

Question 33

What is the treatment for prolactinomas?

Answer 33

cabergoline

Question 34

What is the treatment for GH secreting tumours?

Answer 34

surgey and somatostatin analogues