Brain Tumours Flashcards
What are the common types of primary brain tumour?
Glioma (neuroepitheal tissue)
Meningioma (meninges)
Adenoma (pituitary)
What cancers commonly spread to the brain?
Renal cell carcinoma Lung carcinoma Breast carcinoma Malignant melanoma GI tract cancer
What cells are gliomas derived from?
Astrocytes
What are the characteristics of a meningioma?
Slow growing Extra-axial Usually benign Arise from arachnoid Frequently occur along falx, convexity or sphenoid Usually cured if completely removed
How do brain tumours present?
Raised intracranial pressure
Focal neurological deficit
Epileptic fits
CSF obstruction
What are the symptoms of raised intracranial pressure?
Headache (typically morning) Nausea/vomiting Visual disturbance Somnolence Cognitive impairment Altered consciousness
What are the signs of raised intracranial pressure?
Papilloedema 6th nerve palsy Cognitive impairment Altered consciousness 3rd nerve palsy
When is hydrocephalous linked to brain tumours?
Can be caused by tumours in or close to CSF pathways
Especially in children or posterior fossa tumours
What investigations can help diagnose brain tumours?
History and examination Think of sources of secondary tumours (eg CXR, CT, mammography, biopsy skin lesions) CT scan MRI scan PET scan Angiography Biopsy
What are the presentations of a focal neurological deficit?
Hemiparesis Dysphasia Hemianopia Cognitive impairment Cranial nerve palsy Endocrine disorders
What are the clinical features of Gerstmann’s syndrome?
Acalculia
Agraphia
Finger agnosia
Right/left confusion
What lesions cause Gerstmann’s syndrome?
Left parietal lobe lesions
Where are epilepsy causing lesions found?
Above the tentorium
What are the principles of management of brain tumours?
Corticosteroids (dexamethasone) Treat epilepsy (anticonvulsants) Analgesics/antiemetics Counselling Surgery Radiotherapy Chemotherapy Endocrine replacement
Why would you not do a lumbar puncture when there are symptoms suggesting an intracranial mass lesion?
Can cause meningitis
Can cause herniation syndrome (fatal)
Can cause air embolism
Can worsen symptoms
