Brain Tumours (clinical) Flashcards
What is three types of brain tumours
Metastases
Primary malignant
Primary benign
What is the common metastases brain tumours
Renal Lung Malignant melanoma Breast GI tract
What is a primary malignant brain tumour
Glioma (glioblastoma multiforme)
What is examples of primary benign brain tumours
Meningioma
pituitary adenoma
What do brain tumours present with
Signs of raised intracranial pressure
seizures
neurological deficits
What is the aims of managing brain tumours
Appropriate investigations
ease symptoms
aid effect of adjuvant radiotherapy and chemotherapy
prolong life expectancy
What is symptoms of raided intracranial pressure
Headaches (morning) Nausea/vomiting visual disturbance somnolence cognitive impairment altered consciousness
What is the signs of raised intracranial pressure
pailloedema 6th nerve palsy cognitive impairment altered consciousness 3rd nerve palsy
What is the signs of focal neurological deficit
Hemiparesis dysphasia hemianopia cognitive impairment cranial nerve plays endrocrine disorder
What does seizures indicate about the location of tumour
Lesion located above tentorium
How does CSF obstruction arrises and what does it cause
Tumours in or close to CSF pathway
results in hydrocephalus
How do you diagnose brain tumours
History and examination MRI/CT Biopsy PET Angiogram
What investigation takes place if suspecting metastases
CXR
CT Chest/abdo/pelvis
Biopsy of skin lesions/lymph nodes
What is the overall treatment for brain tumours
Surgery - exision of lesion
Radiotherapy
chemotherapy
coricosteriods
anticonvulsants (treat epilepsy)
anlagesics
endocrine replacement
counselling
What is the costicosterod used to treat brain tumours
dexamethasone
As complete surgical excision of glioblastoma multiform is impossible what is performed instead
debulking of lesions
What is the chemotherapy dug used in treating GBM
temazolamide
What doesn’t occurs in metastasis treatment
Chemotherapy
How is meningioma commonly cured
By surgery
What treatment might be needed in meningioma
anti convulsants
What is the life expectancy of low grade astrocytoma vs high grade astrocytoma
Low grade - long life expectancy
High grade - average i year survival
What is the prognosis of metastases
frequently good medium term remission
Left handed, presents with ataxia and in-coordiantion, where would you suspect lesion to be
Cerebellum
A 44 year old, right handed, woman presents with acalculia, agraphia,
finger agnosia and right/left confusion.
Where would you suspect
her lesion to be?
left (dominant) parietal lobe lesions
= gerstmans syndromme
What is Gerstmanns syndrome
rare neurological disorder that can occur as the result of a brain injury or as a developmental disorder.
The syndrome is characterized by the loss or absence of four cognitive abilities- the agraphia,
dysgraphia,
acalculia,
finger agnosia,
A 30 year old, right handed, man presents with a bi temporal hemianopia.
Where would you suspect
his lesion to be?
Pituitary
50 year old right handed man
Presented to medical team with cognitive language dysfunction:
difficulty reading e mails
difficulty expressing what he wished to say
short-term memory impairment
where do you expect the lesion to be
Left temper-parietal
What is the clinical presentation of glioblastoma multiforme
Decreased level of consciousness
- drowsiness
- headaches and nauseated
