Chapter 10 - Tumors and Traumatic Brain Injury

Question 1

Characteristics of intracranial tumors

Answer 1

• atypical, uncontrolled growth of cells that do not serve a purpose
• grow at the expense of surrounding tissue

Question 2

Infiltrating tumors

Answer 2

• malignant
• invade and destroy neighboring areas of brain tissue

Question 3

Noninfiltrating tumors

Answer 3

• benign
• encapsulated (clear border btwn tissue and tumor) and noninvasive
• easier to remove

Question 4

Malignant tumors

Answer 4

• properties of the tumor cells invade other tissue
• tend to be cancerous
• more likely to grow back if removed
• metastasize (break off and spread)

Question 5

Benign tumors

Answer 5

• abnormal cell growth surrounded by a capsule
• can still create pressure on surrounding tissue
• non-cancerous and easier to remove
• Grades 1-4

Question 6

Glioma

Answer 6

• infiltrating tumor
• tumor formed by glial cells
• most common type

Question 7

Glioblastoma multiforme (GBM)

Answer 7

• 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

Question 8

Astrocytoma

Answer 8

• infiltrating tumor
• developed from astrocytes
• slower growth
• affects cranial nerve
• better prognosis

Question 9

Oligodendroglioma

Answer 9

• infiltrating tumor
• developed from oligodendrocytes
• common in younger people
• rare, slow growing
• good prognosis

Question 10

Meningiomas

Answer 10

• noninfiltrating tumor
• grows w/n meninges (arachnoid layer), creating pressure on the brain
• more common in females

Question 11

Metastatic tumor

Answer 11

• noninfiltrating tumor
• originates from a diff. tumor that broke off
• malignant, but has its own border
• removal depends on whether pt has tumors elsewhere

Question 12

Acoustic neuroma

Answer 12

• noninfiltrating tumor
• develops from Schwann cells in the ear
• progressive benign tumor
• causes symptoms like hearing loss, ringing in the ears, etc.

Question 13

Pituitary tumors

Answer 13

• noninfiltrating tumor
• develops in/on pituitary gland
• nonfunctioning: grows but does not effect release of hormones
• functioning: grows and does effect release of hormones

Question 14

What is the triad of symptoms commonly seen in pts with brain tumors?

Answer 14

• headache
• nausea
• vomiting
• also see loss of cog. functioning and seizures

Question 15

How are brain tumors diagnosed?

Answer 15

• CT
• MRI
• fMRI - can determine which areas are functioning for safe removal
• angiography

Question 16

Tx for brain tumors

Answer 16

• 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

Question 17

What are some of the common causes of traumatic head injuries?

Answer 17

• motor vehicle accidents
• sports injuries
• falls
• violence
• industrial accidents
• most common in young single males

Question 18

Retrograde degeneration

Answer 18

• tearing of the axon degenerates back to the cell body

Question 19

Mechanism of impact of traumatic head injuries

Answer 19

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

Question 20

Anterograde degeneration

Answer 20

• tearing of the cell body leading to the degeneration of the axon and axon terminal
• higher potential for recovery

Question 21

Axonal sprouting

Answer 21

• axon making new connections
• occurs when axon is damaged, but not completely torn

Question 22

Penetrating head injuries

Answer 22

• exactly what it sounds like lmao
• caused by knife, scissors, bullet, or skull fractures lodging in the brain

Question 23

Closed head injuries

Answer 23

• blow to the head, but not penetrating the skull
• deceleration: hit something @ a high speed
• acceleration: hit by something going a high speed

Question 24

Glasgow Coma Scale (GCS)

Answer 24

• used to assess level/severity of a brain injury and the level of a coma
• > 13 indicate mild confusional state
• <5 indicate deep coma

Question 25

Coma

Answer 25

pt cannot open their eyes, make any recognizable sounds, and cannot follow any commands

Question 26

Edema

Answer 26

• swelling of tissue that puts pressure on brain against skull that damages neurons
• causes brain herniation

Question 27

Brain herniation

Answer 27

• displacement of other structures due to pressure
• usually downwards, putting brainstem @ risk

Question 28

Extradural hemorrhage

Answer 28

• bleeding btwn meninges and skull
• trephination to treat

Question 29

Subdural hemorrhage

Answer 29

• bleeding under meninges
• pt will still exhibit normal behavior

Question 30

Intracranial bleeding

Answer 30

• blood vessels in brain burst
• usually due to penetrating injury

Question 31

Post-traumatic epilepsy

Answer 31

• epilepsy most likely caused by scar tissue from penetrating injury
• could occur up to 2 years after injury

Question 32

Concussions

Answer 32

• 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

Question 33

What are the neuropsychological manifestations of TBIs?

Answer 33

• anterograde and retrograde amnesia most common
• attentional deficits
• mood changes like irritability
• problems with concentration