CNS Tumors Flashcards
Primary brain tumors in adults vs children?
Adults supratentorial, children infratentorial
Glial tumors
Astrocytoma, Ependymoma, Oligodentroglioma
Non glial tumors
Neural progenitor origin
Meningioma
Pituitary adenoma
Astrocytoma
20% of neoplasms, life expectancy 5 years.
4 grades, the worst is GBM. If lower grade, can undergo malignant transformation
Best option is complete resection, but can’t resect GBM
Astrocytoma grades
I: Fibrillary astrocytoma
II: Astrocytoma/oligodendroglioma
III:Anaplastic Astrocytoma
IV: Glioblastoma multiforme
Can a brain tumor have variable pathology in different parts?
Yes, but pathology is officially the most malignant portion
Treatment for GBM
Whole brain radiotherapy, if low grade, resection
Oligodendroglioma
5% of glial tumors, present in middle aged females
Can cause frontal lobe seizures. Can debulk and add radio/chemotherapy
Ependymoma
5% of glial cell neoplasms, usually located in the posterior fossa. Most frequently in children/young adults, and can sometimes seed down into the spinal fluid.
Most common intrinsic tumor of the spinal cord?
Ependymoma
Choroid plexus tumors
Cause hydrocephalus by secreting too much CSF. Most common between birth and 10 years. Most common in IV ventricle
Meningioma
Second most common primary intracranial neoplasm, tumor is external to brain and displaces tissue. More common in women after age 40. Can be induced by radiation therapy.
Treatment of meningiomas
Usually not radiosensitive, so surgery or no treatment
Acoustic Neuroma
Schwannoma that cause tinnitus, deafness, compression of other cranial nerves. Surgery is curative. NF2 (neurofibromatosis)
Pituitary adenoma
Can cause acromegaly or gigantism, prolactinoma most common, then GH.
Primary cerebral lymphoma
Steroid sensitive, but poor outcome
Brain metastases
Occur in 20-30% of those with systemic cancer because 15-20% of blood goes to brain.
Most common brain mets?
Lung, breast, melanoma
Most common herniation syndrome?
Subfalcine herniation, doesn’t really have too much symptomatology, but sometimes contralateral leg weakness.
Uncal herniation causes?
Dilated and unreactive pupil on affected side, LOC, contralateral OR ipsilateral (due to Kernohan’s notch) hemiparesis.
Kernohan’s notch?
Uncal herniation can also cause ipsilateral hemiparesis because it pushes midbrain over and is compressed on the other side.
Tonsillar herniation causes?
Cardiac and breathing malfunction.
Vasogenic edema?
BBB becomes leaky, treat with steroids. Trauma/tumors
Cytotoxic edema?
Problem with cells, can’t treat with steroids. Altitude sickness, pseudotumor cerebri.
