Exam 2: Brain Tumors/Brain Abscesses/Spinal Cord Trauma Flashcards
Tumors can occur as ________ or _________ brain tumors.
Primary → Start in brain
Secondary → Metastasis to brain
Brain tumors have a very similar to patho ___.
TBI
Talk through the patho of brain tumors:
Cerebral edema, inflammation of brain tissue
→ Inc ICP
→ Neuro deficits
→ Cerebral ischemia
Hydrocephalus
Pituitary dysfunction (some cases)
→ DI and SIADH
Main classification of brain tumors (simple)
Benign
→ Noncancerous
→ Meningioma
→ Remove surgically
→ Typically have a positive outcome
Malignant
Metastatic
→ Malignant and metastatic require aggressive tx
→ Radiation
→ Chemo
→ Surgery
What are the 2 secondary classifications?
Supratentorial
→ Within the vertebral hemisphere, above tentorium (dural fold)
Infratentorial
→ Beneath the tentorium, brainstem and cerebellum
Symptoms of supratentorial?
Paralysis
Seizures
Mem loss
Impaired cognition
Vision issues
Symptoms of infratentorial?
Ataxia
ANS problem
Hearing
Vision
Drooling
The etiology of brain tumors is primarily __________.
Unknown.
Genetics? Mutations? Environmental?
Malignant brain tumors are seen primarily in ppl ages ___ - ___.
40-70
→ Survival rate is lower than other cancers
Name some signs and symptoms of brain tumors:
Similar to TBI and increased ICP
→ Sensory perception
→ Cognition
→ Mobility
→ HA (especially when waking up)
→ Seizures
→ Speech impairment
→ Alteration in smell
→ Hearing loss
Aside from getting a history and assessment, what other diagnostics would we do re: brain tumors:
CT head
MRI
X-ray
Lumbar puncture
Various labs
Interventions are based on __________, _________, and __________.
Size, type, and location.
What are some nonsurgical interventions for brain tumors?
Radiation
Chemo
Monoclonal AB
Immunotherapy
Recombinant DNA
Experimental drugs
Stereotactic radiosurgery
What is a craniotomy?
Surgery to remove / debulk tumor
Risk of damaging healthy tissue - non tumor brain tissue
How is endoscopy surgery used?
Used to remove small tumors
→ Pituitary tumors
4 (general) types of meds used for brain tumor symptom management.
Steroids
Anti-epileptics
Antiemetics
Pain meds
What are some complications we worry about post-surgery?
Inc ICP
Hydrocephalus
→ Ventriculostomy
→ Surgical shunt
Brain bleed
→ Subdural and epidural hematomas, intracranial bleeding
Resp complication
Wound infection
Meningitis
Diabetes insipidus
SIADH
Time for brain abscesses!
or abthetheth as Pendy would say
Patho behind abscesses?
Patho
→ Purulent collection that occurs in brain
Causes
→ Bacterial
→ Fungal
What is the most common source of this infiltrate (place in the body)?
LUNGS
→ Could also come from ears, sinus cavity, blood stream (indirect) or access to brain (direct)
In which lobes are abscesses most common (2)?
Temporal and frontal lobes
What kind of s/s will we see with an abscess?
Neuro
→ HA
→ Neuro deficits
→ Symptoms of inc ICP
Visual deficits
→ Nystagmus
MS
→ Weakness
→ Ataxia
Fever
Diagnostics for brain abscesses?
CBC
Culture
→ Blood
→ Cultures from the possible site of origin
Lumbar puncture
Needle biopsy
CT scan
EEG
MRI
Interventions for brain abscesses?
IV abx
Anti-epileptics
Analgesics
Drain
→ Craniotomy
→ Burr hole
That was quick. On to spinal cord trauma.
LFG
What are 3 type of spinal cord tumors?
Intramedullary, extramedullary,
Metastasis → tumor that arise from other areas and got to the spinal cord, nerves, or vert
What is an intramedullary tumor?
Cells w/i the cord
→ Gliomas, astrocytoma, ependymomas
What is an extramedullary tumor?
Tumor w/i the membrane around cord or nerve roots
→ Tumor is outside the cord but impacts spinal cord function
What is a metastasis tumor?
Tumor that arises from other areas and got to the spinal cord, nerves, or vertebrae
Spinal cord tumors are more common for folks who have what 2 diseases?
Neurofibromatosis 2
→ Disorder characterized by the growth of noncancerous tumors in the nervous system)
Van hipple landau disorder
→ Rare disease that causes tumors and cysts to grow in your body.
Signs and symptoms of spinal cord tumors?
VARIES
but
Neurological problems
Sensory perception alteration
Difficulty walking
→ Up to paralysis
Falls
Muscle weakness
→ Mild - severe
Pain
→ Usually at site of tumor
→ Back pain or radiating pain
Compression of spinal cord
Loss of movement
Loss of sensation
Loss of bowel and bladder function
Paralysis
Early symptoms easily overlooked
→ Back pain, typically worse at night
Loss of bowel and bladder function
Spinal cord tumors may cause permanent _________ damage.
Nerve
Aside from permanent nerve damage, what are 2 other complications spinal tumors can cause?
Compression of spinal cord
→ Loss of movement
→ Loss of sensation
→ Loss of bowel and bladder function
Paralysis
If caught early, the goal is __________ treatment.
Aggressive
→ May prevent further loss of function and possibly regain function
