Brain Tumours (Clinical) Flashcards
What are the cancers which most commonly spread to the brain?
Renal Lung Breast Melanoma GI
What are the most common primary brain tumours?
GIioma
Meningioma
Adenoma
What is the most common cause of cancer in the brain?
Secondary metastasis
What is the most common grade of glioma? Describe this stage
Grade 4
Most aggressive, glioblastoma multiform spread by tracking through the white matter and CSF pathway, very rarely spread systemically
What cells do gliomas affect?
Astrocytes
What are the characteristics of meningioma?
Slowing growing extra-axial tumours that are usually benign. They arise form the arachnoid mater and frequently occur along the falx or sphenoid bone
If complete resection successful the patient is usually cured
What is the most common form of pituitary tumour?
Adenoma
Only 1% malignant
What are some of the effects of a ‘benign’ pituitary adenoma?
Visual disturbance caused by compression of the optic chiasm but he tumour, can cause hormone imbalance by the functioning hormone-secreting forms of at the adenoma
What are some basic presenting features of brain tumours?
Raised ICP
Focal neurological deficit
Epileptic fits
CSF obstruction
Give some symptoms of raised ICP
Headache - typically morning Nausea/vomiting Visual disturbance Somnolence Cognitive impairment Altered consciousness
What are some clinical signs of raised ICP?
Papilloedema 6th nerve palsy Cognitive impairment Altered consciousness 3rd nerve palsy
What is the average production of CSF in an adult?
400-500 cc per day
What can cause hydrocephalus and whom does this most commonly affect?
Tumours in or close to the css pathways, especially in the posterior fossa
Children
Give some focal neurological deficits
Hemiparesis Dysphagia Hemianopia Cognitive impairment Cranial nerve palsy Endocrine disorders
What are the two general forms of epilepsy?
Focal epilepsy
Generalised epilepsy
What positional feature of tumours dictates whether they have the potential to cause epileptic fits?
This inly occurs in lesions above the tentorium
What are the cerebral imaging options for brain tumours?
CT
MRI
PET
(Angiography)
What are the management goals in brain tumours?
Accurate tissue diagnosis
Improve quality of life
Aid affect of adjuvant therapy
Prolong life expectancy
What are the management options for Glioblastoma multiforme?
Complete surgical excision possible - biopsy or debunk possible
Medical - steroids, anticonvulsants
Radiotherapy
Chemotherapy
What are the management options for metastasis to the brain?
DIAGNOSE PRIMARY SITE
Medical - steroids, anticonvulsants
Radiotherapy - whole brain, stereotatic
Surgery
What is the general prognosis for meningioma?
Commonly cured by surgery, may require anticonvulsants
What is the general prognosis for low grade astrocytoma?
Long life expectancy
What is the general prognosis for high grade astrocytoma/GBM?
Average 1 year survival
