Brain tumours (clinical) Flashcards
List the 3 main common types of primary brain tumour
pituitary adenoma
gliomas
meningioma
What is the most aggressive type of glioma?
GBM
Most likely cancers causing secondary cerebral metastases
renal cell carcinoma breast carcinoma melanoma lung carcinoma GI tract
Are brain primary or secondary tumours more common?
secondary
What are gliomas derived from?
astrocytes
How does GBM spread?
through white matter and CSF pathway
What does meningiomas derive from?
arachnoid
Characteristics of meningiomas
slow growing and benign
Location of meningiomas
along falx or sphenoid bone
What % of pituitary adenomas are malignant?
1%
Effects of pituitary adenoma
visual disturbance and hormone imbalance
4 clinical presentations of brain tumours
raised ICP
focal neurological defecit
epilepsy
CSF obstruction
List some symptoms of raised ICP
morning headache visual disturbance nausea and vomiting somnolence cognitive impairment altered consciousness
Signs of raised ICP
papilloedema
3rd/6th nerve palsy
cognitive impairment
altered consciousness
How much CSF produced per day?
400-450 cc
3 main features of brain tumours that can result in hydrocephalus
posterior fossa
children
in or near CSF pathway
Diagnosing brain tumour
biopsy
CT/MRI
history and examination
sources of 2nd tumours eg CXR
What is meant by focal neurological defecit? examples
hemiparesis hemianopia dysphasia cognitive impairment cranial nerve palsy endocrine disorders
Ataxia
Lack of voluntary movement and co-ordination of muscle movements
Are lesions above or below tentorium likely to cause epilepsy?
above
Investigations of brain tumour
imaging eg CT/MRI/PET/ angiography
CT chest/abdo/pelvis
biopsy skin lesions
mammography
List some treatments of brain tumours
surgery radiotherapy chemotherapy CCS anticonvulsants analgesics and antiemetics endocrine replacement counselling
Managing GBM
no surgery - only biopsy or debulk
CCS and anticonvulsant
radio and chemo
Managing mets
confirm diagnosis and surgery
CCS, radio and anticonvulsant
Prognosis of astrocytoma, meningioma and mets
astrocytoma: low grade - good, GBM - 1 yr
meningioma: surgery cures and anticonvulsant
mets - good medium term remission
