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Neurology > CNS Neoplasms > Flashcards

CNS Neoplasms Flashcards

1
Q

Primary Malignant Brain Tumors

A

Men > Women

More frequent in children

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2
Q

Risk Factors for Brain Tumors

A

Genetic mutation
Neurofibromatosis
Exposure to high dose ionizing radiation

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3
Q

High Dose Ionizing Radiation Possibilities

A

Radiation therapy
Atomic bomb survivors
CT scans
Dental xrays

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4
Q

Classification of CNS Neoplasm

A

Grade 1: benign
Grade 2: malignant
Grade 3: malignant tissue that has cells that are actively growing
Grade 4: malignant tissue has cells that look most abnormal and tend to grow quickly

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5
Q

Tumor Classifications

A

Neuroglial (Glioma)
Meningioma
Schwannoma

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6
Q

Neuroglial (Glioma) Subtypes

A

Astrocytoma
Oligodendroglioma
Ependymoma

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7
Q

Schwannoma Subtype

A

Acoustic neuroma

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8
Q

Astrocytic Tumor Subtypes

A

Glioblastomas

Astrocytomas

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9
Q

Astrocytic Tumor Grading

A

Grade 1: benign (almost always diagnosed in childhood)
Grade 2: slow growing and invade surrounding tissue
Grade 3: rare and require aggressive treatment due to tentacle like growth are hard to resect
Grade 4: aggressive fast growing cancer (Glioblastoma)

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10
Q

Glioblastoma

A 
Highly malignant
60-75% of all astrocytomas
Difficult to remove
Survival 2 years
Treatment: surgery, radiation, and chemotherapy
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11
Q

Oligodendroglioma

A

Can be grade II-III
Frontal, temporal lobe
Slow growing

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12
Q

Main Presenting Symptom of Oligodendroglioma

A

Seizure

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13
Q

Frontal Lobe Oligodendroglioma

A

Weakness on one side of the body
Personality changes
Behavior changes
Difficulty with short term memory

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14
Q

Treatment of Oligodendroglioma

A

Surgery
Radiation
Chemotherapy

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15
Q

Prognosis of Oligodendroglioma

A

Survival 4-10 years

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16
Q

Ependymal Cells

A

Cells line the ventricles of the brain and center of the spinal cord

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17
Q

Ependymoma

A

More common in children

Peak at age 5-6 and 20-30

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18
Q

Intracranial Ependymoma

A

Most common in kids
Poor prognosis
Symptoms of increased ICP: hydrocephalus, headache, N/V, ataxia, strabismus, irritability, altered mental status

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19
Q

Spinal Cord Ependymoma

A

Most common in adults
Better prognosis
May cause cord compression symptoms
Most common spinal cord tumor

20
Q

Meningioma

A

20-30% of primary brain tumors

Most common primary brain tumor

21
Q

Meningioma Facts

A

More common in women
Benign
Usually grow inward putting pressure on brain and spinal cord
Can grow outward and cause thickening of the skull

22
Q

Treatment of Meningioma

A

Surgery

Radiation

23
Q

Meningioma Prognosis

A

5 year survival rate: 73-94%

24
Q

Meningioma Symptoms

A

Irritation: seizures
Compression: HA, focal weakness, dysphagia, apathy, somnolence
Stereotypic: CN deficits, change in mentation, visual changes, anosmia, exopthalmos, tongue atrophy
Vascular: compression of cerebral arteries
Misc: hydrocephalus, panhypopituitarism

25
Q

Tumors of the Cranial and Paraspinal Nerves

A

Schwannoma
Neurofibroma
Perineurioma
Malignant Peripheral Nerve Sheath Tumor

26
Q

Schwannomas

A

Nerve sheath tumor
Relatively slow growing
Mostly benign
Acoustic neuromas are the most common

27
Q

Acoustic Neuroma

A

Arises from 8th cranial nerve
Benign
Slow growing
Can cause serious complications

28
Q

Acoustic Neuroma Symptoms

A 
Unilateral hearing loss
Tinnitus
Occasional dizziness
Difficulty swallowing
Impaired eye movement
Taste disturbance
Unsteadiness
29
Q

Treatment of Acoustic Neuroma

A

Surgical excision
Stereotactic radiation surgery
Followed by observation fro growth

30
Q

Outcome and Prognosis Neuroma

A

Tinnitus- up to 60% relieved
Recurrence- less that 5% (observe for 10 years)
Hearing- preserved in 80%
Facial Nerve Dysfunction: variable

31
Q

Primary CNS Lymphoma

A

Common in immunodeficiency syndromes
Derived from B lymphocytes
Occurs in the cerebral hemispheres

32
Q

Treatment of CNS Lymphoma

A

Steroids to decrease brain edema
Chemotherapy
Radiation

33
Q

Metastatic Tumors

A

Most common brain tumor

34
Q

Most Common Cancers to Metastasize to the Brain

A 
Lung (16-20%)
Renal Cell Cancer (7-10%)
Malignant Melanoma (7%)
Breast (5%)
Colon (1-2%)
35
Q

Treatment of Metastatic Tumors

A

Radiation

Chemotherapy

36
Q

Neurologic Presentation of Generalized Tumors

A 
Headaches
Seizures
N/V
Depressed LOC
Nerocognitive Dysfunction
37
Q

Neurologic Presentation of Focal Tumors

A 
Seizures
Weakness
Sensory loss
Aphasia
Visual spatial dysfunction
38
Q

Symptoms of CNS Tumors

A 
Headache
Seizure
Syncope
N/V
Numbness, tingling, weakness
Balance issues
Cognitive dysfunction
39
Q

Cognitive Dysfunction Symptoms

A 
Personality changes
Changes in memory, attention
Altered language ability
Problems with executive functioning
Change in daily patterns of eating and sleeping
40
Q

Tumor Headaches in CNS Tumors

A 
Dull, constant
Bilateral, not throbbing
Occipital/frontal lobes
Increased coughing or straining
Worse with change in body position
Worse at night
N/V
Change in pattern from usual headache
41
Q

Most common symptoms of gliomas and cerebral metastases

A

Seizures

42
Q

Medical Management of Symptoms

A

Headache/brain edema- steroids

Seizures- anticonvulsants

43
Q

Imaging in Primary Care for CNS Tumors

A

MRI with gadolinium

44
Q

Neurosurgical Workup of CNS tumors

A

+/- lumbar puncture to examine cells
+/- cerebral angiogram
Biopsy

45
Q

Treatment of CNS Tumors

A

Surgical resection
Chemotherapy
Radiation

Neurology (10 decks)

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