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Neurology > Brain Tumours > Flashcards

Brain Tumours Flashcards

1
Q

What are the 2 general types of brain tumour?

A

Primary

Secondary metastatic

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2
Q

In primary tumors, what are the different type?

A

Glioblastoma
Meninges
Pituitary

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3
Q

What are the commonest tumours which spread to the brain?

A 
Renal cell
Breast
Lung 
Malignant melanoma
GI tract
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4
Q

What is the most common type of brain tumour?

A

Metastatic brain tumours

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5
Q

What cells are gliomas derived from?

A

Astrocytes

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6
Q

What stage is a GBM?

A

Stage IV

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7
Q

What are classed as primary malignant tumours?

A

Gliomas

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8
Q

In which meningeal layer do meningiomas usually present

A

Arachnoid

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9
Q

Where fo meningiomas usually present in the brain?

A

Along falx, convexity or sphenoid bone

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10
Q

Are meningiomas curable?

A

Yes by surgical excision

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11
Q

What is the common signs of pituitary adenoma?

A

Optic field defect - bitemporal hemianopia

hormone imbalance

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12
Q

What are the clinical presentations of a brain tumour?

A

Raised intracranial pressure
Focal neurological signs
Epileptic fit
CSF obstruction

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13
Q

What are the main symptoms of raised ICP?

A 
Headache 
Nausea/ vomiting 
Diploia or blurred vision 
Drowsiness
Cognitive impairment
Alter consciousness
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14
Q

What are the signs of raised ICP?

A

Papilloedema
3rd nerve palsy
6th nerve palsy
Altered consciousness

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15
Q

What is a RED FLAG sign of raised intracranial pressure?

A

Headache - worse in morning

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16
Q

What investigations would you do if suspected brain tumour?

A

CT scan (brain)
MRI
PET

CXR
Biopsy - skin or lymph
Mammography

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17
Q

What are some focal neurological deficits which may be observed?

A 
Dysphagia 
Hemiparesis 
Hemianopia
Cognitive impairment 
Cranial nerve palsy 
Endocrine disorders
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18
Q

Patient presents with ataxia & incoordination, where is the lesion?

A

Cerebellum

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19
Q

Right handed patient presents with acalculia, agraphia, finger agnosia, left/ right confusion, where is the lesion?

A

Left parietal lobe

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20
Q

If patient presents with bitemporal hemianopia, where is the lesion?

A

Pituitary

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21
Q

If right handed patient presents with difficulty reading, difficulty expressed self, short term memory loss, where is the lesion?

A

Left temper-parietal area

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22
Q

What are the main management goals?

A

Reduce size of tumour (debunk)

Improve focal neurological signs

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23
Q

What type of management is available?

A

Steroids
Anticonvulsants
SuRgery
Radiotherapy

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24
Q

Are GBM operable?

A

Yes but not curative only debulk or biopsy

25
Q

What treatment would be administered in someone with metastatic brain tumours?

A

Surgery

Radiotherpay

26
Q

What is the prognosis for GBM?

A

1 YRS

27
Q

What is the prognosis for meningioma?

A

Commonly cured with surgery

28
Q

What is the prognosis for metastatic disease?

A

Medium term remission

29
Q

Why do you NOT perform lumbar puncture in someone with brain tumour?

A

Risk of herniation syndrome and patient death

30
Q

What tumours are classed as primary benign?

A

Pituitary adenoma

Meningioma

31
Q

What are the presenting signs of brain tumour?

A

Raised ICP - nausea, headache, drowsiness
Focal neurological signs
Cognitive impairment

32
Q

What are the names of the dural sheets which divide the brain?

A

Falx cerebri

Tentorium cerebelli

33
Q

What are the localised lesion causes of increased intracranial pressure?

A

Haemtoma (haemorrhage)
Tumour
Abscess

34
Q

What are some of the generalised causes of increased ICP?

A

Oedema post trauma

35
Q

What are localised lesions also referred to as?

A

Space Occupying Lesions (SOL)

36
Q

What types of herniation can occur what increased ICP?

A

Uncal herniation
Subfalcine (midline shift)
Coning - cerebellotonsillar herniation

37
Q

Why is it called a subfalcine shift?

A

Falcine means falx therefore below falx cerebri

38
Q

In an uncle herniation what happens?

A

Brain herniates inferiorly below tentorium

39
Q

Cerebellar tonsil herniation causes what?

A

Brain stem death

40
Q

What are some of the initial signs & symptoms of Increased ICP?

A

Morning headache & nausea

Papilloedema

41
Q

What are some of the progressive signs of increased ICP?

A

Pupillary dilation
Falling GCS score
Brainstem death

42
Q

What are the different types of gliomas?

A

Glioblastoma
Astrocytoma
Oligodendroctoma
Ependymoma

43
Q

What is the cell type found in medulloblastomas?

A

Embryonic neural cells

44
Q

What are meningiomas formed from?

A

Arachnoid cell

45
Q

What tumours occur from nerve sheath cell?

A

Neurofibroma

Schwannoma

46
Q

What tumour arises from blood vessels?

A

Haemangioblastoma

47
Q

Which tumour type is a malignant childhood tumour?

A

Medulloblastoma

48
Q

Where do the majority of brain tumours occur in adults/children?

A

Above tentorium

Below tentorium

49
Q

Which cells do gliomas descend from?

A

Glial cells

50
Q

Are gliomas malignant or benign?

A

Malignant

51
Q

Which cells are glioblastomas formed from?

A

Astrocytes

52
Q

What shape do astrocytes look like?

A

Star shaped

53
Q

Where are medulloblastomas usually found?

A

In posterior fossa, in children

54
Q

Are meningiomas benign or malignant?

A

Malignant

55
Q

Where are schwannomas found?

A

Peripheral nerve sheaths

56
Q

What is an acoustic neuroma?

A

Schwannoma of the 8th cranial nerve

57
Q

What is the main sign of an acoustic neuroma?

A

Unilateral hearing loss

58
Q

What is a pituitary adenoma?

A

Benign tumour of the pituitary gland

Neurology (16 decks)

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