brain tumours and head injury Flashcards
symptoms of brain tumour?
headaches
vomiting
mental changes
seizures
headache that wakes someone up
red flag
Invstigations for brain tumour
CT MRI LP PET Lesion biopsy EEG
which type of cancer commonly metastasises to the brain/
lung
how are they graded?
WHO grading system
grade 1 astrocytoma - malignant?
benign
how to low grade astrocytomas present?
seizures
low grade astrocytomas, are they dangerous?
they are not benign
grade 2 astrocytoma treatment?
radio and chemo
what do grade 2 astrocytomas become?
glioblastoma (G2G)
most common primary brain tumour?
glioblastoma
In head trauma you get release of?
excitatory amino acids (glutamate and aspartate)
which receptors do glutamate and aspartate bind to?
NMDA
get release of intracellular ___ after head trauma?
calcium. Release of intracellular calcium, activation of phospholipases, breakdown of cell membrane, cell swelling, activation of apoptosis.
aim for cerebral perfusion pressure of what after head injury?
60mmHg
In base of skull fracture, you get what signs in anterior cranial fossa fracture?
panda/racoon eyes
middle cranial fossa fracture?
battle sign over mastoid
Eyes pneumonic for Glasgow Coma Scale
- (E)yes Closed
- (Y) shaped sharp pricking object (responds to pain)
- (E)ar piercing noise (responds to voice)
- (S)pontaneous (opens eyes spontaneously)
Voice pneumonic for glasgow coma scale
Voiceless - 1 OOOh -- obscure incoherent sounds - 2 Inappropriate words - 3 Confused and Disorientated - 4 Elegant speech and orientated - 5
Pain - glasgow coma scale neumonic?
old ben
- obeys commands
- localises to pain
- draw away
- bend/flexion (decorticate posture by pain)
- extension (decerebrate posture by pain)
- no motor response (motionless)
minimum score you can get on GCS?
3
a coma equates to a GCS score of ?
8 or less
what can’t a patient do in a coma ?
does not open eyes, does not obey commands, does not speak
when should you request a CT scan?
any patient with a skull fracture
or not orientated
focal neurological signs
taking anti coagulants
why sedate in head injury?
reduces metabolic rate
reduces cerebral blood flow
reduces ICP
what does mannitol do?
improves Microperfusion
what are the late effects of head injury?
epilepsy, CSF leak and cognitive problems
