Brain Tumours

Question 1

Who is more at risk of brain tumours - women on men?

Answer 1

women

Question 2

What is the general presentation of brain tumours?

Answer 2

neurological deficit
motor weakness
headache (raised ICP signs too)
seizures

Question 3

What is the first investigation for a suspected brain tumour?

Answer 3

MRI

CT if contraindicated

Question 4

What is the best investigation for a suspected brain tumour?

Answer 4

biopsy

Question 5

What are the majority of brain tumours?

Answer 5

METASASIS

Question 6

Whats the most common type of primary brain tumours?

Answer 6

glioblastoma multiforme

Question 7

Describe a grade 1 astrocytoma?

Answer 7

children/young adults
benign, slow growing
operate before it gets too big

Question 8

Describe a grade 2 astrocytoma?

Answer 8

temporal or frontal lobe
malignant
poor prognosis if other risk factors

Question 9

How do you treat a grade 2 astrocytoma?

Answer 9

surgery

then chemo and radiotherapy

Question 10

Describe grade 3 anaplastic astrocytoma?

Answer 10

arises de novo

median survival 2 years

Question 11

What appearance do grade 4 glioblastoma multiforme have on MRI?

Answer 11

butterfly appearance

Question 12

Describe grade 4 glioblastoma multiforme?

Answer 12

spread via white matter
most common primary tumour
often in older patients 60-70s
median survival = 14 months

Question 13

How do you treat grade 4 glioblastoma multiforme?

Answer 13

surgery and radiotherapy

Question 14

Where are oligodendroglial tumours usually found?

Answer 14

frontal lobe

Question 15

What is the presentation of oligodendroglial tumours?

Answer 15

25-45yrs
seizures
headaches

Question 16

What do oligodendroglial tumours look like on MRI?

Answer 16

white toothpaste appearance

appear calcified

Question 17

What is the treatment of oligodendroglial tumours?

Answer 17

chemotherapy, surgery and radiotherapy

Question 18

What causes foster kennedy syndrome?

Answer 18

meningioma in the olfactory groove

Question 19

How does foster kennedy syndrome present?

Answer 19

optic atrophy in the ipsilateral eye

papillodema in the contralateral eye

Question 20

What are the characteristics of meningiomas?

Answer 20

90% are benign
females>males
arise from the meninges - think NF type 2

Question 21

What is the presentation of meningiomas?

Answer 21

CN palsy

headaches

Question 22

What investigation do you do for meningiomas?

Answer 22

MRI - see meningial involvement

CT - see bone involvement

Question 23

What is the treatment for meningiomas?

Answer 23

excise if causing a problem

CRAP ones reoccur - clear cell, choroid, rhaboid, papillary

Question 24

What is an acoustic neuroma?

Answer 24

nerve sheath tumour derived from schwann cells, arises in the cerebellopontine angle

Question 25

What is the presentation of acoustic neuromas?

Answer 25

30-50yrs
hearing loss
tinnitus
balance problems
hydrocephalus

Question 26

What is the treatment of acoustic neuromas?

Answer 26

surgery and radiotherapy

Question 27

How do Pineal tumours present?

Answer 27

parinaud syndrome 
(tumour of pineal gland)
nystagmus
coordination problmes
headaches

Question 28

Where do hemangioblastomas form?

Answer 28

posterior fossa

Question 29

How do hemangioblastomas present?

Answer 29

benign
cerebellar dysfunction symptoms
raised ICP
associated with von-hippie landau syndrome

Question 30

What are the most common brain mets?

Answer 30

bronchus
breast 
kidney
thyroid
colon

Question 31

Where do most tumours arise in children?

Answer 31

below the tentorium cerebelli

Question 32

Where do most tumours arise in adults?

Answer 32

above the tentorium cerebelli

Question 33

What is the most common childhood cancer?

Answer 33

medulloblastoma

Question 34

How does medulloblastomas present?

Answer 34

occur in the midline so distrupt CSF flow so present with hydrocephalus

Question 35

What is the treatment for medulloblastomas?

Answer 35

radiotherapy