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Neurology System > CNS Tumours Clinical > Flashcards

CNS Tumours Clinical Flashcards

1
Q

What is the aetiolgoy of brain tumours?

A

Primary unknown
Genetic
Metastatic causes

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2
Q

What are the most common primary sites of brain metastases?

A 
Lung 
Kidney 
Breast 
GI 
Melanoma
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3
Q

How are CNS tumours classified?

A

Based on tissue of origin
Location
Primary or secondary
Grading

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4
Q

How are tumours graded?

A

GX Grade cannot be assessed (Undetermined)
G1 Well-differentiated (Low grade)
G2 Moderately differentiated (Intermediate grade)
G3 Poorly differentiated (High grade)
G4 Undifferentiated (High grade)

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5
Q

How do CNS tumours present?

A

Depends on location, size and type of tumour

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6
Q

What are the general signs and symptoms of CNS tumours?

A 
Increased ICP 
Causing:
Headaches worse in morning 
Nausea 
Vomiting 
Papilleedema 
Cognitive impairment 
Altered consciousness 
Focal neurologic deficits
Seizures
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7
Q

What are the signs and symptoms of cerebral tumours?

A 
Headache 
Vomiting 
Hemiparesis 
Hemiplegia 
Hypokinesia
Seizures 
Changes in personality or behaviour
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8
Q

What are the signs and symptoms of brainstem tumours?

A 
o	Hearing loss (acoustic neuroma)
o	Facial pain and weakness
o	Dysphagia, decreased gag reflex
o	Nystagmus
o	Hoarseness
o	Ataxia
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9
Q

What is the sign in cerebellar tumours?

A

Disturbances in co-ordination and equilibrium

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10
Q

What are the signs and symptoms of a pituitary tumour?

A 
Endocrine dysfunction
Visual deficits (pressure on the optic chiasma)
Headache
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11
Q

What are the signs and symptoms of a frontal lobe tumour?

A 
Inappropriate behavior
Personality changes
Inability to concentrate
Impaired judgment
Memory loss
Headache
Expressive aphasia
Motor dysfunctions
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12
Q

What are the signs and symptoms of a parietal lobe tumour?

A

Sensory deficits
Paresthesia
Loss of 2 pt discrimination

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13
Q

What is the sign of a occipital lobe tumour?

A

Visual disturbances

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14
Q

What are the classifications of intra-axial tumours?

A
  • Gliomas
    1. Astrocytoma (Grades
    I,II)
    2. Anaplastic
    Astrocytoma(III)
    3. Glioblastoma
    Multiforme(IV)
  • Oligodendroglioma
  • Ependymomas
  • Medulloblastoma
  • CNS Lymphoma
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15
Q

What are the classifications of an extra-axial tumour?

A 
Meningioma 
Metastatic 
Acoustic neuromas 
Pituitary adenoma 
Neurofibroma
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16
Q

What are the characteristics of meningiomas?

A

Slow growing
Attached to meninges
Usually benign

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17
Q

What is the 2nd most common primary brain tumour?

A

Meningioma

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18
Q

Where do meningiomas arise from?

A

Arachnoid cap cells from arachnoid membrane

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19
Q

Are meningiomas invasive?

A

Not usually

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20
Q

Do meningiomas affect more F or M?

A

F

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21
Q

What are the symptoms of meningioma?

A 
Generally slow growing so asymptomatic for ages 
Headaches 
Blurred vision 
Numbness 
Speech problems 
Seizures
22
Q

What imaging is done for meningioma?

A

CT

MRI

23
Q

What other investigation can be done for meningioma?

A

Biopsy

24
Q

What is the scale for astrocytomas?

A
  • Low grade astrocytomas
  • Diffuse low grade astrocytomas
  • Glioblastomas
25
Q

What is the presentation of diffuse low grade astrocytoma?

A

Seizures
Headache
Slowly progressive neurological deficits

26
Q

Which is the most common primary type of brain tumour in adults?

A

High grade glioblastoma

27
Q

Where are high grade glioblastomas usually located?

A

Cerebral hemispheres

28
Q

Where are diffuse grade astrocytomas usually located?

A

Frontal region

29
Q

How do high grade glioblastomas present?

A

Seizures
Headache
Slowly progressive neurological deficits

30
Q

Where do oligodendrogliomas arise from?

A

Myelin

31
Q

Where are oligodendrogliomas located?

A

Superficially in frontal lobes

32
Q

What is the presentation of oligodendrogliomas?

A

Seizures
Headache
Slowly progressive neurological deficits

33
Q

What are investigations for oligodendrogliomas?

A

CT

MRI

34
Q

Are brain mets single or multiple?

A

Can be either

35
Q

What investigations should be used to diagnose CNS tumours?

A

CT
MRI
PET scan

36
Q

Which investigation is most widely used for the diagnosis for brain tumours?

A

CT

37
Q

What is CT more useful for than MRI?

A

Detecting acute haemorrhage, calcification and bony involvement

38
Q

What are the benefits of MRI scanning for brain tumours?

A

More sensitive than CT scan
Can detect small tumours
Provides much greater anatomical detail
Good for visualising tumours of the skull base, brain stem and posterior fossa tumours

39
Q

What is the surgical treatment for CNS tumours?

A

Resection

Biopsy

40
Q

When might you use a transsphenoidal route?

A

Approach through nasal pasage to remove pituitary tumour

41
Q

What does radiation therapy?

A

Damages DNA of rapidly dividing cells

42
Q

What does chemotherapy do?

A

Slows cell growth

43
Q

What is the purpose of performing a biopsy?

A

To remove a piece of the tissue to determine the type of tumour

44
Q

What are the risk factors for CNS tumours?

A

Often unknown
FH
Ionizing radiation
Environmental hazards

45
Q

What investigation is contraindicated in CNS tumours?

A

LP

46
Q

What is the treatment for glioblastoma?

A 
Complete excision impossible 
Biopsy or debulk 
Radiotherapy 
Corticosteroids 
Anticonvulsants
47
Q

What is the most common pituitary tumour?

A

Pituitary adenoma

48
Q

What would bitemporal hemianopia suggest?

A

Pituitary tumour

49
Q

What are red flags for CNS tumours?

A 
Weight loss
Anorexia 
Focal neurological deficit 
Change in headache 
Worse in morning headache 
Signs of increased ICP 
Vomiting 
Seizures
50
Q

What is the treatment for pituitary adenoma?

A

Endocrine replacement
Transsphenoidal surgery
Drug therapy
Radiotherapy

Neurology System (35 decks)

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