Brain Tumours Flashcards
a tumour is unlikely to bleed T or F
T
children tend to get what kind of brain tumours?
infratentorial neoplasms
what is a sign of an infratentorial neoplasm?
walking on tiptoes due to problematic cerebellar coordination
hydrocephalus
brain tumours are more common in adults than children T or F
F, 2nd most common cancer in children
general presentation of a brain tumour
progressive neuro deficit motor weakness headache seizures behaviour changes
frontal lobe controls what functions?
personality
micturition
gait
what eye problem will a left occipital lobe tumour give?
right homonomous hemianopia
3 causes of increased pressure in the brain
blood eg haemorrhage
brain swelling
inc CSF
increased IC pressure produces what symptoms?
headaches
vomiting
mental changes
seizures
why can a swollen brain cause CN3 palsy
CN3 runs along the side of the brainstem as swollen CSF presses on the uncus
what diuretic is used to relieve pressure in the brain?
mannitol
what eye sign would make you think the brain is swollen
blown pupil
how does the brain physiologically control its own pressure
constricts arterioles to prevent blood entry
what kind of headache makes you think it could be a brain tumour
worse in the morning (WAKES THEM UP)
worse on cough/leaning forward
get nausea too
migraine/tension headache-like
2nd eye doesn’t adduct, other eye has nystagmus is indicative of…
MS
how does the brain try to physiologically respond to raised ICP? what is this process called?
increased BP
bradycardia
irregular resp
= cushings triad
Ix for suspected brain tumour
- CT for big things or blood
MRI for tissue definition and chronic bleed - lesion biopsy to confirm tumour type
main red flag screen for mets?
are they bleeding from anywhere??
what cells in the brain do glial tumours arise from?
- astrocytes
2. oligodendrocytes
Tx for grade 1 astrocytoma
surgery (curative)
grade 1 astrocytomas are benign T or F
T
who gets grade 1 astrocytomas
children and young people
low grade premalignant astrocytomas tend to present with…
seizures
low grade pre maignant astrocytomas tend to present in the __ lobe
temporal
what factors affect the prognosis of an astrocytoma
age >50 focal deficit short duration of symptoms raised ICP altered consciousness
should you operate on a benign tumour
yes if it is growing as it is premalignant
Tx of grade 2 astrocytoma
surgery +/- :
radiation
chemo
combo of radio and chemo
grade 2 astrocytomas can become what kind of tumour?
glioblastoma
what brain tumour patients are not allowed to drive?
glioblastoma patients due to seizure risk
patients who have had seizures in the past yr
those with visual field defects
who gets oligodendroglial tumours? where do they usually arise?
adults (25-45 yrs)
frontal lobe
main presentation of oligodendroglial tumour?
seizures
which glial tumour shows up with calcification?
oligodendroglial tumour
Tx for ODG tumours?
surgery + chemo (very chemosensitive)
a meningioma tends to arise from what cells
arachnoid cap cells
meningioma symptoms?
headaches
cranial nerve neuropathies
menigiomas are benign T or F
T
name the4 types of malignant meningioma
CCRaP clear cell chordoid rhabdoid papillary
which type of tumour presents with a “dural tail” on MRI
meningioma
Tx of meningiomas?
pre-op embolisation (look at vasculature of tumour)
surgery
radiotherapy
name the 3 types of nerve sheath tumour
schwannoma aka neuroma
neurofibroma
MPST (malignant peripheral nerve sheath tumour)
most common schwannoma? what condition makes you likely to get it?
vestibular affecting CN8
NF 2
an acoustic neuroma makes you likely to get what complication in the brain?
hydrocephalus (blocks 4th ventricle)
Tx of acoustic neuroma?
radiation
surgery
manage hydrocephalus
complications of acoustic neuroma
CN7 palsy
corneal reflex problems
nystagmus
who gets germ cell tumours?
children and teens (usually boys)
Ix for germ cell tumours?
CT
most common CNS germ cell tumour?
germinoma
blood tests for a suspected midline tumour in a child?
ALP
b-HCG
LDH
Tx for hydrocephalus?
VP shunt
