Brain tumours Flashcards
where do meningiomas arise form
which part of the brain are they found in
meninges (dura)
the outside bit (where the dura is) = next to the skull
are meningiomas usually benign or malignant
benign (99%)
what is the pneumonic for malignant meningiomas
CCRaP
Clear cell
Choroid
RhAbdoid
Papillary
common cause of malignant meningiomas
post radiotherapy (eg got radiotherapy as a kid)
presentation of meningiomas
asymptomatic (bc most benign)
?CN neuropathies
raised ICP symptoms - headache, blurred vision
investigtaions for ?meningioma
CT, MRI
CT appearance of meningioma
‘skull blistering’
MRI appearance of meningioma
dural tail
patent dural sinuses
meningioma treatment
surgery
?chemo if symptomatic
most common type of extrinsic brain tumour (outwith the brain tissue)
meningioma
which extrinsic brain tumour is associated with neurofibromatosis and presents with hearing loss
acoustic neuroma
where is the tumour in acoustic neuromas
nerve sheath of CN VIII
what is the most common type of intrinsic brain tumour (within the brain itself)
metastasis
grade I intrinsic brain tumour name (1)
pilocytic astrocytoma
who get grade I intrinsic brain tumours (pilocytic astrocytoma)
are they curable
via what method of treatment
kids/young adults
yes high cure rate via surgery
grade II intrinsic brain tumour name (2)
diffuse astrocytoma
oligodendroglioma
why MUST grade II/III tumours be removed
can progress to glioblastomas (grade IV tumours)
grade III intrinsic brain tumour name (1)
anaplastic astrocytoma
grade IV intrinsic brain tumour name (1)
glioblastoma multiforme (GBM)
as you progress from grade I to grade IV intrinsic brain tumors, does prognosis improve or decrease
decreased
grade I curable
grade IV <1year survival
prognosis of grade IV intrinsic brain tumour (glioblastoma)
<1 year
who get glioblastomas (grade IV intrinsic brain tumour)
elderly
what type of intrinsic brain tumour has calcification on MRI
what grade is it
oligodendroglial cell tumour
grade II (same as diffuse astrocytoma)
in which lobe do oligodendroglial tumours occur
hence present with what symptom
frontal lobe
seizures
which type of brain tumour is benign, highly vascular and associated with hippel-landau syndrome (renal carcinomas, phaemochromocytoma)
haemangioblastoma
how does a cerebellar tumour present (7)
which side - ipsilateral or contralateral
DANISH
dysdiadochokinesis ataxia - broad based gait nystagmus - do H test intention tremor - do finger to nose test slurred speech hypotonia - reduce tone
ipsilateral
how does a temporal lobe tumour present
seizures
memory deficits
wernickes aphasia
contralateral superior quadrantanopia
how does a frontal lobe tumour present
personality changes brocas aphasia (expressive aphasia) hemiparesis - note motor not sensory bc motor is more anterior in the brain than sensory = frontal lobe
how does a parietal lobe tumour present
hermisensory loss - note sensory note motor bc motor Is more anterior in the brain = frontal lobe
gertsmann syndrome - inability to write (dysgraphia), difficulty understanding maths, R/L confusion
which lobe does a tumour in cause difficulty understanding maths, inability to write (dysgraphia) amd L/R disorientation
what is this called
parietal lobe tumour
gertsmann syndrome
how does an occipital lobe tumour present
visual hallucinations
contralateral homonymous hemianopia
as well as specific symptoms depending on where the tumour is, what symptom Is associated with the headache
what makes the headache worse
headache associated with vomiting
headache worse on coughing
investigations for ?brain tumour
MRI
biopsy
fundoscopy - for papilloedema
which investigation is diagnostic of the type of brain tumour
biopsy - MRI just confirms theres one there
which investigation is used to confirm there is a brain tumour present
MRI
what is given to patients acutely with ?brain tumour with raised ICP
mannitol
treatment of all brain tumours
surgery to remove it +/- radiotherapy +/- chemo
just surgery fine if benign and low chance of recurrence/progression to malignancy
what tpe of chemo is used for brain tumours
temozolomide (TMZ)
what is the first line treatment for oligodendroglial tumours
chemo - temozolomide (TMZ)
cerebellar tumoru
ipsilateral or contralateral
ipsilateral problems
everything but cerebellar tumour
ipsilateral or contralateral
contralateral
3 types of brain cancer in kids
which is more common
astrocytoma - common
pineal tumours - rare
germ cell tumours
how do kids with astrocytomas present
tiptoeing gait
vomiting with headache
treatment of astrocytoma in kids
surgery
where is a pineal tumour
how does it look on MRI
in the pinea - just behind the lateral ventricles
on MRI - looks like sugar coating on pinea
