CNS Tumors Flashcards
What is the primary imaging study for the neurological system?
What are the pros to this imaging study ?
1.
2.
3.
You use contrast for ___________ or ___________
CT scan.
1. Cheap
2. Quick
3. Can determine need for further imaging like CTA or MRI
infection or tumors
Just like the CT, an MRI with contrast is used to detect infection or tumors. An MRI is much better for looking at ______________. It is the best test for ____________ and _____________.
In T1, water appears _____________ while in T2 it appears _______________.
soft tissue
brain, spine
dark, light
The Monroe kellie doctrine states that the skull has a certain volume and if we had more volume to that “fixed box” then the pressure begins to rise. Normal ICP is _________________ and we start to get concerned when the ICP is __________________
7-15= normal
20-25= concern
What are the focal symptoms that are present in someone with elevated ICP
AMS, pupil abnormalities, loss of cough or gag reflex
The goal of elevated ICP is to reduce it in the least invasive way possible. How is it managed?
- Maintain HOB at 30, neck in good alignment
- steroids for edema from tumors, mannitol to draw fluid out of the brain
- Hyperventilation to decrease CO2 from causing vasoconstriction and decreasing cerebral blood flow (LAST RESORT BC ISCHEMIA)
- Ventricular drain to drain CSF and reduce volume in the skull
- Decompressive hemicraniectomy - remove piece of skull
_______________ are the most common type of primary CNS tumor. It is an abnormal growth of the meninges, specifically the ________________, covering the brain and spinal cord. This is more common in women and men and the median age of diagnosis is 65.
meningioma
arachnoid
There are numerous types of gliomas and they are named based on the cell line which is malignant. ________________ is the most common type. _____________________ is not a particular type of tumor, it is a term used to describe a high grade glioma
astrocytoma
glioblastoma multiforme
__________________ brain tumors are the most frequent type of tumors to arise in the brain. ______________ is the most frequent met followed by breast and melanoma. ___________ and _____________ are the most common mets for the spine.
mets
lung
lung
breast
What are the risk factors for meningiomas?
advanced age
ionizing radiation exposure
genetics
obesity
What are the risk factors for metastatic tumors?
smokers > lung ca
higher risk of brain mets in older patients with cancer
small cell lung CA has a high propensity of metastasizing to the brain
What are the risk factors for gliomas?
advanced age
radiation exposure
What is the most common presenting symptoms for patients with brain tumors? What are some others associated with brain tumor?
headache
seizures, altered neurological status (change in speech, memory, affect or confusion)
What are the symptoms of a frontal lobe tumor?
hemiparesis, aphasia, gait dysfunction, personality change
What are the symptoms of a parietal lobe tumor?
contralateral sensory or motor dysfunction, homonymoous neglect, aphasia for dominant lobe. dominant lobe is left side for most people lefties have a slightly higher rate of right brain dominance
What are the symptoms of a temporal lobe tumor?
auditory or perceptual changes, memory loss, aphasia for dominant lobe tumors