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Neuro > Brain tumours > Flashcards

Brain tumours Flashcards

1
Q

Three examples of primary tumours

A

Neuroepithelial tissue - glioma (glioblastoma multiforme)
Meninges - meningioma
Pituitary - adenoma

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2
Q

Brain tumours commonly occur seconday to…

A 
Renal cell carcinoma
Lung
Breast
Malignant melanoma
GI tract
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3
Q

Metastases

A

15-30%
9% cerebral metastasis only detectable site of spread
Increasing incidence

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4
Q

Gliomas

A

Derived from astrocytes - structural and nutritional support to nerve cells
WHO Grade I-IV

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5
Q

Which part of the brain mater do meningiomas arise from?

A

Arachnoid

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6
Q

Where do meningiomas occur?

A

Along the flax, convexitty or sphenoid bone

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7
Q

Which pituitary tumour is most common?

A

Adenoma

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8
Q

What signs and symptoms occur in pituitary tumours?

A

Visual disturbance - compression of optic chiasm

Hormone imbalance

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9
Q

Which structure will pituitary tumours compress?

A

Optic chiasm

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10
Q

Clinical presentation of patient with brain tumour

A

Raised ICP
Focal neurological deficit
Epileptic fits
CSF obstruction

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11
Q

Symptoms of raised ICP

A 
Headache (morning)
Nausea and vomiting
Visual disturbance
Somnolence (sleepy/drowsy)
Cognitive impairment
Altered consciousness
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12
Q

Signs of raised ICP

A 
Papilloedema
6th nerve palsy
Cognitive impairment
Altered consciousness
3rd nerve palsy
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13
Q

When does hydrocephalus typically occur?

A

With tumours close to CSF pathways
Posterior fossa tumours
Children

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14
Q

Diagnosis of hydrocephalus

A 
History and exam
CXR for source of primary tumour
CT
MRI
Biopsy
Retinal photograph - papilloedema
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15
Q

Examples of focal neurological deficit

A 
Hemiparesis
Dyshpagia
Hemianopia
Cognitive impairment (memory, direction)
Cranial nerve palsy
Endocrine disorders
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16
Q

Diagnostic test for cerebellar lesion

A

MRI

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17
Q

What is Gerstmann’s syndrome?

A

Loss of 4 cognitive abilities due to lesion

  1. Acalculia - Arithmetic
  2. Agraphia, Dysgraphia
  3. Finger agnosia - can’t recognise, indicate fingers
  4. Cannot distinguish right and left
18
Q

Management of Gerstmann’s syndrome

A

Investigative imaging - MRI
Surgery to alleviate causative issue eg partietal lobe lesions
Address developmental issues - education, rehabilitation, counselling

19
Q

Focal or generalised seziures (epilepsy) will only occur if lesions are above which area?

A

Above the tentorium

20
Q

Investigations indicated if ?metastasis

A 
CT
MRI
PET
CT chest/abdo/pelvis
Mammography
Biopsy skin lesions/lymph nodes
21
Q

Principle treatment in SOL

A 
Corticosteroids (dexamethasone)
Treat epilepsy
Analgesics/antiemetics
Counselling
Surgery
Radiotherapy
Chemotherapy
Endocrine replacement
22
Q

Management for glioblastoma

A

Surgical excision - biopsy or debulk
Medical - steroids, anticonvulsants
Radiotherapy
Chemotherapy - Temazolamide

23
Q

Management of metastasis to brain

A

Medical
Radiotherapy - whole brain or stereotactic
Surgery

24
Q

Management of meningioma

A

Common;y cured by surgery

May require anticonvulsants

25
Q

Prognosis for astrocytomas

A

Low grade - long life expectancy

High grade or GBM – average 1 year survival

26
Q

Should lumbar puncture be perfromed where signs of intracranial mass lesion are present?

A

NO

Leads to meningitis, herniation syndrome, air embolism, worsen headache

27
Q

Complications of lumbar puncture

A

Meningitis
Air embolism
Herniation syndrome
Worsen headache

28
Q

What is the Monro Kellie Doctrine?

A

Three components of tissue, blood and CSF exist in equilibrium to maintain fixed volume and ICP

29
Q

Space occupying lesions can disrupt the ICP leading to??

A

Herniation

30
Q

What is the function of the falx cerebri and tentorium cerebelli?

A

Fibrous sheets preventing excessive movement

31
Q

Examples of space occupying lesions

A

Blood
Tumour
Abscess

32
Q

Most concerning herniation

A

Uncal

Cerebellotonsillar

33
Q

What structure is impacted in an uncal herniation?

A

Aqueduct crushed and narrowed - flow of CSF

34
Q

Subfalcine herniation causes what visible change?

A

Midline shift

35
Q

Swelling and shift of tissue due to SOL causes what zone around the tumour?

A

Ischaemic zone

36
Q

Morning headaches and sickness occur due to which change in tissue in case of SOL?

A

Squeeze on cortex and brainstem

37
Q

Papilloedema is caused by increased pressure where?

A

On optic nerve

38
Q

3 signs of ICP increase

A

Pupillary dilation - strectching CN III

  1. Falling GCS
  2. Brain stem death
39
Q

Name tumours of nerve sheath cells

A

Schwannoma, neurofibroma

40
Q

Where do CNS tumours commonly occur in adults?

A

Above tentorium

41
Q

Where do CNS tumours commonly occur in children?

A

Below tentorium

42
Q

Nerve sheath tumour causing unilateral deafness

A

Vestibulocochlear nerve CN VIII schwannoma

Benign

Neuro (9 decks)

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