Chapter 10 - Tumors and Traumatic Brain Injury Flashcards
Characteristics of intracranial tumors
- atypical, uncontrolled growth of cells that do not serve a purpose
- grow at the expense of surrounding tissue
Infiltrating tumors
- malignant
- invade and destroy neighboring areas of brain tissue
Noninfiltrating tumors
- benign
- encapsulated (clear border btwn tissue and tumor) and noninvasive
- easier to remove
Malignant tumors
- properties of the tumor cells invade other tissue
- tend to be cancerous
- more likely to grow back if removed
- metastasize (break off and spread)
Benign tumors
- abnormal cell growth surrounded by a capsule
- can still create pressure on surrounding tissue
- non-cancerous and easier to remove
- Grades 1-4
Glioma
- infiltrating tumor
- tumor formed by glial cells
- most common type
Glioblastoma multiforme (GBM)
- infiltrating tumor
- grade 4 tumor formed by glial cells
- hard to remove
- symptoms occur w/n 3 weeks
- death occurs w/n 6-12 mnths
Astrocytoma
- infiltrating tumor
- developed from astrocytes
- slower growth
- affects cranial nerve
- better prognosis
Oligodendroglioma
- infiltrating tumor
- developed from oligodendrocytes
- common in younger people
- rare, slow growing
- good prognosis
Meningiomas
- noninfiltrating tumor
- grows w/n meninges (arachnoid layer), creating pressure on the brain
- more common in females
Metastatic tumor
- noninfiltrating tumor
- originates from a diff. tumor that broke off
- malignant, but has its own border
- removal depends on whether pt has tumors elsewhere
Acoustic neuroma
- noninfiltrating tumor
- develops from Schwann cells in the ear
- progressive benign tumor
- causes symptoms like hearing loss, ringing in the ears, etc.
Pituitary tumors
- noninfiltrating tumor
- develops in/on pituitary gland
- nonfunctioning: grows but does not effect release of hormones
- functioning: grows and does effect release of hormones
What is the triad of symptoms commonly seen in pts with brain tumors?
- headache
- nausea
- vomiting
- also see loss of cog. functioning and seizures
How are brain tumors diagnosed?
- CT
- MRI
- fMRI - can determine which areas are functioning for safe removal
- angiography
Tx for brain tumors
- surgery is the best option
- radiation shrinks tumor for easier removal
- chemotherapy alters DNA of tumor and kills it, most effective when tumor is actively dividing
- psychotherapy
What are some of the common causes of traumatic head injuries?
- motor vehicle accidents
- sports injuries
- falls
- violence
- industrial accidents
- most common in young single males
Retrograde degeneration
- tearing of the axon degenerates back to the cell body
Mechanism of impact of traumatic head injuries
shearing and stretching of axon occurs w/ a blow to the head, but if it stretches too much, it can result in either retrograde or anterograde degeneration
Anterograde degeneration
- tearing of the cell body leading to the degeneration of the axon and axon terminal
- higher potential for recovery
Axonal sprouting
- axon making new connections
- occurs when axon is damaged, but not completely torn
Penetrating head injuries
- exactly what it sounds like lmao
- caused by knife, scissors, bullet, or skull fractures lodging in the brain
Closed head injuries
- blow to the head, but not penetrating the skull
- deceleration: hit something @ a high speed
- acceleration: hit by something going a high speed
Glasgow Coma Scale (GCS)
- used to assess level/severity of a brain injury and the level of a coma
- > 13 indicate mild confusional state
- <5 indicate deep coma
Coma
pt cannot open their eyes, make any recognizable sounds, and cannot follow any commands
Edema
- swelling of tissue that puts pressure on brain against skull that damages neurons
- causes brain herniation
Brain herniation
- displacement of other structures due to pressure
- usually downwards, putting brainstem @ risk
Extradural hemorrhage
- bleeding btwn meninges and skull
- trephination to treat
Subdural hemorrhage
- bleeding under meninges
- pt will still exhibit normal behavior
Intracranial bleeding
- blood vessels in brain burst
- usually due to penetrating injury
Post-traumatic epilepsy
- epilepsy most likely caused by scar tissue from penetrating injury
- could occur up to 2 years after injury
Concussions
- shearing and stretching of neurons after blow to head, but pt does not lose consciousness
- often go unnoticed
- cumulative in effect - can lead to neuronal death if neurons aren’t given time to heal, can progress to other neurodegenerative diseases
What are the neuropsychological manifestations of TBIs?
- anterograde and retrograde amnesia most common
- attentional deficits
- mood changes like irritability
- problems with concentration
