CNS: Brain Tumours and Head Injuries Flashcards
How many brain tumours are primaries?
50%
50% are metastatic
Primary tumours that often metastasise to brain?
Lymphoma Breast Lung Prostate GI tract
Potential symptoms of a brain tumour (5)
Depends on the part of the brain they occupy
- New epilepsy
- Hydrocephalus
- Focal neurology deficit
- Balance or gait problems
- Visual defects in pituitary tumour
How are brain tumours different to other tumours?
Can cause death even if benign by raising ICP, pushing brain stem, and pressing on adjacent structures
Made worse by oedema and haemorrhage
First line investigations for brain tumour
CT or MRI
Where do gliomas arise from?
From supporting neuroglia (includes astrocytomas, oligodendrogliomas, ependymomas)
Where do neuroblastomas arise from?
Neurones
Where do meningiomas arise from?
Meninges
Where do Shwannomas or neurofibromas arise from?
Cranial nerves
Definitive diagnosis of brain tumour?
Histology from brain biopsy or brain smear
Treatment of brain tumour
Surgery but site is important
Chemoradiotherapy but only specific options which can cross BBB. Also lots of side effects on brain function, cognition, vision
Proton beam therapy
True/false: Primitive neuroectodermal tumours are slow growing tumours most commonly seen in YAs
False, they are rapidly growing tumours in children
True/false: Most brain tumours in children are in the posterior fossa
True, over 70%
True/false: meningiomas are associated with alterations in gene locus at 22q12
True, this is the neurofibromatosis 2 gene
True/false: Astrocytomas can be recognised by Glial Fibrillary Acidic Protein (GFAP) positivity on IHC
True
True/false: Orimary lymphomas of the CNS are linked with immunosuppression and are usually B cell in origin
True
Types of diffuse head injuries?
Diffuse axonal
Diffuse vascular
Hypoxic ischaemic damage
Diffuse brain swelling
Abrasion
Scratch/graze
Laceration
Cut/tear
Incisions
Slashes
Stab wounds
Penetrating wounds
Black eye
Orbital contusion
Causes of a black eye (3)
- Direct blunt force to the orbit
- Injury to the front of the scalp (blood tracks downward)
- Fracture of the base of skull superio-posterior to eye, causing raccoon eyes
Linear skull fracture
May be due to blunt impact, appears as a line on skull surface or within the base
Comminuted fracture
When an impact shatters the skull into multiple pieces
What injury can a hammer cause to the skull?
Circular depressed fracture
Hinge fracture
A fracture across the base (or any part) of the skulls where two pieces move relative to one another
May be caused by fall or RTC
Coup
COntusion beneath impact
