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Neurology > CNS tumours > Flashcards

CNS tumours Flashcards

1
Q

Define CNS tumours? and what are they differenitated into?

A

tumours of the central nervous system

High grade- tumour that grows rapidly and agressively

low grade= tumour that grows slowly and may or may not be successfully treated

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2
Q

Give examples of high grade CNS tumours?

A

Glioma and glioblastoma multiforme

Primary cerebral lymphoma

Medulloblastoma - cerebellar dysfunction as are usually located within cerebellar veins

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3
Q

Give examples of low grade CNS tumours?

A

Meningioma

Acoustic neuroma

Neurofibroma

Pituitary tumour

Craniopharyngeoma- in sella turcica

Pineal tumour

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4
Q

what are the common cancers that cause brain mets?

A

Lung

Breast

Stomach

Prostate

Thyroid

Colorectal

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5
Q

what are the risk factors for CNS tumours?

A

Ionising radiation

Immunosuppression (e.g. HIV)

Inherited syndromes (e.g. neurofibromatosis, tuberous sclerosis)

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6
Q

Summarise the epidemiology of CNS tumours?

A

Primary brain tumours = 2% of tumours diagnosed in the UK

AIDS patients have an increased risk of developing CNS tumours

Can develop at any age but are more common between 50-70 yrs

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7
Q

what are the presenting symptoms and signs of CNS tumours?

A

Presentation depends on the size and location of the tumour

Headache (worse in the morning and when lying down)

Nausea and vomiting

Seizures

Progressive focal neurological deficits

Cognitive and behavioural symptoms

Papilloedema

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8
Q

what is the difference between positive symptoms and negaitve symptoms?

A

negative symptoms- deficits caused by direct pressure/tumour invasion

positive symptoms - due to localised seizure activity caused by irritation of the brain parenchyma

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9
Q

what are the negative symptoms of the temporal lobe?

A

Wernicke’s aphasia

superior homonymous quadrantanopia

auditory agnosia

prosopagnosia (difficulty recognising faces)

Amnesia

Odd/inexplicable phenomena

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10
Q

what are the signs of cerebellar damage?

A
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11
Q

what are the negative symptoms of the frontal lobe?

A

Hemiparesis

Personality change

Broca’s dysphasia: non-sluent, laboured and halting speech

Unilateral anosmia (smell)

Cant create lists

Concrete thinking

Executive dysfunction

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12
Q

what are the negative symptoms of the parietal lobe?

A

Contralateral Hemisensory loss

Reduced two point discrimination

Ipsilateral Sensory inattention

Apraxia

Tactile agnosia: astereognosis

Inferior homonymous quadrantanopia

Dysphasia

Gerstmann’s syndrome (lesion of dominant parietal): alexia, acalculia, finger agnosia and right-left disorientation

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13
Q

what are the negative symptoms of the occipital lobe?

A

Contralateral visual field defects - homonymous hemianopia (macular sparing)

Cortical blindness

Visual agnosia

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14
Q

what are the negative symptoms of schwannomas?

A

Progressive deafness

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15
Q

what is the affect of damage to Wernicke’s area?

A

results in the inability to understand language, however, patients will be able to produce fluent, but nonsensical, speech

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16
Q

what is the affect of damage to Broca’s area?

A

located in the frontal lobe of the dominant hemisphere, is responsible for speech production. Damage to Broca’s area leads to an inability to produce fluent speech, despite intact understanding of language.

17
Q

what is the affect of damage to arcuate fasciculus?

A

The arcuate fasciculus connects Wernicke’s and Broca’s areas. Lesions of the arcuate fasciculus results in intact language comprehension and fluent speech production; however, speech repetition is poor.

18
Q

what is the role of the hippocampus?

A

component of the limbic system-> memory and learning

19
Q

what is the role of the amygdala?

A

limbic system-> fight or flight response

20
Q

what are the appopriate investigations for CNS tumours?

A
  • Bloods - check CRP/ESR to eliminate other causes (e.g. temporal arteritis)
  • CT/MRI-> (may want to CT abdomen and thorax to see if it is a secondary tumour)
  • Biopsy and tumour removal
  • Magnetic resonance angiography - define changing size and blood supply of the tumour
  • PET

Neurology (29 decks)

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