Exam 2: Brain Tumors/Brain Abscesses/Spinal Cord Trauma

Question 1

Tumors can occur as ________ or _________ brain tumors.

Answer 1

Primary → Start in brain
Secondary → Metastasis to brain

Question 2

Brain tumors have a very similar to patho ___.

Answer 2

TBI

Question 3

Talk through the patho of brain tumors:

Answer 3

Cerebral edema, inflammation of brain tissue
→ Inc ICP
→ Neuro deficits
→ Cerebral ischemia
Hydrocephalus
Pituitary dysfunction (some cases)
→ DI and SIADH

Question 4

Main classification of brain tumors (simple)

Answer 4

Benign
→ Noncancerous
→ Meningioma
→ Remove surgically
→ Typically have a positive outcome
Malignant
Metastatic
→ Malignant and metastatic require aggressive tx
→ Radiation
→ Chemo
→ Surgery

Question 5

What are the 2 secondary classifications?

Answer 5

Supratentorial
→ Within the vertebral hemisphere, above tentorium (dural fold)

Infratentorial
→ Beneath the tentorium, brainstem and cerebellum

Question 6

Symptoms of supratentorial?

Answer 6

Paralysis
Seizures
Mem loss
Impaired cognition
Vision issues

Question 7

Symptoms of infratentorial?

Answer 7

Ataxia
ANS problem
Hearing
Vision
Drooling

Question 8

The etiology of brain tumors is primarily __________.

Answer 8

Unknown.
Genetics? Mutations? Environmental?

Question 9

Malignant brain tumors are seen primarily in ppl ages ___ - ___.

Answer 9

40-70
→ Survival rate is lower than other cancers

Question 10

Name some signs and symptoms of brain tumors:

Answer 10

Similar to TBI and increased ICP
→ Sensory perception
→ Cognition
→ Mobility
→ HA (especially when waking up)
→ Seizures
→ Speech impairment
→ Alteration in smell
→ Hearing loss

Question 11

Aside from getting a history and assessment, what other diagnostics would we do re: brain tumors:

Answer 11

CT head
MRI
X-ray
Lumbar puncture
Various labs

Question 12

Interventions are based on __________, _________, and __________.

Answer 12

Size, type, and location.

Question 13

What are some nonsurgical interventions for brain tumors?

Answer 13

Radiation
Chemo
Monoclonal AB
Immunotherapy
Recombinant DNA
Experimental drugs
Stereotactic radiosurgery

Question 14

What is a craniotomy?

Answer 14

Surgery to remove / debulk tumor
Risk of damaging healthy tissue - non tumor brain tissue

Question 15

How is endoscopy surgery used?

Answer 15

Used to remove small tumors
→ Pituitary tumors

Question 16

4 (general) types of meds used for brain tumor symptom management.

Answer 16

Steroids
Anti-epileptics
Antiemetics
Pain meds

Question 17

What are some complications we worry about post-surgery?

Answer 17

Inc ICP
Hydrocephalus
→ Ventriculostomy
→ Surgical shunt
Brain bleed
→ Subdural and epidural hematomas, intracranial bleeding
Resp complication
Wound infection
Meningitis
Diabetes insipidus
SIADH

Question 18

Time for brain abscesses!

Answer 18

or abthetheth as Pendy would say

Question 19

Patho behind abscesses?

Answer 19

Patho
→ Purulent collection that occurs in brain
Causes
→ Bacterial
→ Fungal

Question 20

What is the most common source of this infiltrate (place in the body)?

Answer 20

LUNGS
→ Could also come from ears, sinus cavity, blood stream (indirect) or access to brain (direct)

Question 21

In which lobes are abscesses most common (2)?

Answer 21

Temporal and frontal lobes

Question 22

What kind of s/s will we see with an abscess?

Answer 22

Neuro
→ HA
→ Neuro deficits
→ Symptoms of inc ICP
Visual deficits
→ Nystagmus
MS
→ Weakness
→ Ataxia
Fever

Question 23

Diagnostics for brain abscesses?

Answer 23

CBC
Culture
→ Blood
→ Cultures from the possible site of origin
Lumbar puncture
Needle biopsy
CT scan
EEG
MRI

Question 24

Interventions for brain abscesses?

Answer 24

IV abx
Anti-epileptics
Analgesics
Drain
→ Craniotomy
→ Burr hole

Question 25

That was quick. On to spinal cord trauma.

Answer 25

LFG

Question 26

What are 3 type of spinal cord tumors?

Answer 26

Intramedullary, extramedullary,

Metastasis → tumor that arise from other areas and got to the spinal cord, nerves, or vert

Question 27

What is an intramedullary tumor?

Answer 27

Cells w/i the cord
→ Gliomas, astrocytoma, ependymomas

Question 28

What is an extramedullary tumor?

Answer 28

Tumor w/i the membrane around cord or nerve roots
→ Tumor is outside the cord but impacts spinal cord function

Question 29

What is a metastasis tumor?

Answer 29

Tumor that arises from other areas and got to the spinal cord, nerves, or vertebrae

Question 30

Spinal cord tumors are more common for folks who have what 2 diseases?

Answer 30

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.

Question 31

Signs and symptoms of spinal cord tumors?

Answer 31

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

Question 32

Spinal cord tumors may cause permanent _________ damage.

Answer 32

Nerve

Question 33

Aside from permanent nerve damage, what are 2 other complications spinal tumors can cause?

Answer 33

Compression of spinal cord
→ Loss of movement
→ Loss of sensation
→ Loss of bowel and bladder function
Paralysis

Question 34

If caught early, the goal is __________ treatment.

Answer 34

Aggressive
→ May prevent further loss of function and possibly regain function