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Neurology Clinical > Brain Tumours > Flashcards

Brain Tumours Flashcards

1
Q

What classification of brain tumour is a glioma?

A

A tumour do neuroepithelial tissue

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2
Q

What classification of brain tumour is a meningioma?

A

Tumour of meninges

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3
Q

What is the common type of pituitary tumour?

A

Adenoma

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4
Q

What are the most common causes of secondary metastasis to the brain?

A 
Renal cell carcinoma
Lung cxarcinoma
Breast carcinoma
Malignant melanoma 
GI tract
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5
Q

What type of cells are gliomas derived from?

A

Astrocytes

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6
Q

What grade is gliomas?

A

Grade IV

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7
Q

Where are glioblastomas most commonly found?

A

In the anterior and middle fossae

Not normally found int he posterior cranial fossa

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8
Q

What type of brain tumours are slow growing and fast growing?

A

Slow growing = meningiomas

Fast growing = gliomas

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9
Q

Are meningiomas benign or malignant?

A

Benign

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10
Q

From what meninges does a meningioma derive form?

A

Arachnoid matter

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11
Q

Where does meningiomas common arise ?

A

Along the falx, sphenoid bone , convexity (surface)

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12
Q

What is the presentation of a pituitary tumour?

A

Visual disturbance

Hormone imbalance

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13
Q

What investigations would you carry out if you suspected a brain tumour?

A

CT/MRI head
CXR
Biopsy

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14
Q

What is the clinical presentation of a brain tumour?

A

Focal neurological deficits
Raised ICP
Epileptic fits
CSF obstruction

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15
Q

What are the signs and symptoms of raised ICP?

A 
Headache - particularly morning
Nausea and vomiting 
Visual disturbances (diplopia, blurred vision)
Somnolence 
Altered conciousness
Pappiloedema 
Cranial nerve palsies (CN III & VI)
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16
Q

How do you identify pappiloedema on fundoscopy?

A

Non defined optic disc margins

Haemorrhages

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17
Q

What are the signs of Grestmanns syndrome and what causes this?

A

Acalculia
Agraphia
Finger agnosia
Right/left confusion

Occurs with parietal lesion

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18
Q

Epilepsy is a symptom of brain tumours that only lie where?

A

Above the tentorium - in the cerebral hemisphere

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19
Q

What is the treatment for glioblastoma?

A

Debulk tumour (complete excision is impossible)
Steroids, anti convulsants
Radiotherapy, chemotherapy

20
Q

What is the best chemotherapy drug for treating glioblastoma?

A

Temazolamide

21
Q

What is the prognosis for a high grade astrocytoma (glioblastoma)?

A

Average 1 year survival

22
Q

What is the prognosis for a meningioma?

A

Commonly cured by surgery, may require anticonvulsants

23
Q

Is a glioblastoma a high or low grade astrocytoma?

A

High grade astrocytoma

24
Q

Why do you not perform a LP if a patient has suspected intracranial mass lesion?

A

A mass lesion = raised intracranial pressure

Performing a LP will therefore cause herniation syndrome (coning)

25
Q

what is the cause of a generalised pathology causing raised intracranial pressure? (not a SOL)

A

oedema post trauma

26
Q

if there is raised ICP and it causes a part of the right cerebral hemisphere to be pushed over to the left, what type of herniation is this?

A

subfalcine herniation (midline shift)

27
Q

if there is herniation of the cerebrum moving inferiorly under the tentorium, what is this called?

A

unal herniation

28
Q

if there is herniation of the brain through a skull fracture what is this called?

A

transcalvarial herniation

29
Q

due to raised ICP, what sign would you see if the brain was squeezing on the optic nerve?

A

papilloedema

30
Q

due to raised ICP, what sign would you see if the brain was squeezing on the cortex and brainstem?

A

morning headaches and nausea

falling glasgow coma scale

31
Q

what can also cause morning headaches (not including raised ICP)?

A

hypoglycaemia through he night

32
Q

if there is squeeze on the CN III due to raised ICP, what sign would you see?

A

pupillary dilatation

33
Q

name a type of brain tumour derived from brain cells?

A

gliomas - glioblastoma, astrocytoma, ependymoma

34
Q

name a brain tumour derived from arachnoid cells.

A

meningioma

35
Q

are medulloblastomas benign or malignant?

A

malignant

36
Q

in what age group would you find meduloblastomas?

A

children

37
Q

what is the distribution of brain tumours with adults compared to children?

A

brain tumours more commonly occur above the tentorium in adults and below in children

38
Q

what is the general appearance of gliomas?

A

diffuse edges

not encapsulated

39
Q

are gliomas benign of malignant?

A

malignant but don’t spread outside the CNS

40
Q

what is the pathology of astrocytomas?

A

bland cells on microscopy similar to normal astrocytes

grow very slowly

41
Q

what is the pathology of glioblastoma?

A

cellular, atypical tumour with necrosis
grow quickly
large cell with multiple nuclei and irregular nucleus

42
Q

from what cells are medulloblastomas derived from and what is the pathology like?

A

neuroectodermal cells
(primitive neural cells)

sheets of small undifferentiated cells

43
Q

what is the pathology of meningiomas?

A

benign but can be locally aggressive
slow growing
bland cells forming small groups
sometimes calcification

44
Q

name an example of a shwannoma and describe its pathology.

A

vestibulocochlear nerve schwannoma - acoustic neuroma
occurs at angle between pons and cerebellum
causes unilateral deafness
benign

45
Q

describe the pathology of CNS lymphoma.

A

high grade neoplasm
usually diffuse Bcell lymphoma
often deep and central site in the brain

46
Q

why is CNS lymphoma difficult to treat?

A

often deep and central site within brain so difficult to biopsy
drugs don’t cross BBB

47
Q

name a brain tumour of blood vessels and where it commonly occurs.

A

haemangioblastoma

most often in cerebellum

Neurology Clinical (21 decks)

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