Exam 3 tumors Flashcards
How many brain tumors prevalence?
63,000 new in adults
4,000 in children
increase is due to better Dx rather than more happening
What are the age ranges most common? and what is a term for this?
0-15
50-70
Bimodal
location of the tumor determines what?
impairments and functional limitations that result
which tumor type is most common?
meningioma 34.4% benign
next most common tumor?
glioblastoma 16.7% malignant
primary brain tumors
originate in CNS
typically don”t metastasize due to lack of lymphatics in the CNS
Glioma origin
from glial cells 42%
cerebral cortex, brain stem, optic nerve, spinal cord
benign in children, malignant in >75y/o
Types of gliomas
astrocytomas
oligodendroglioma
ependymoma
medulloblastoma
Types of primary brain tumors
glioma meningiomas pituitary adenoma Schwannomas primary CNS lymphomas
Astrocytomas
most common
“contained”–less likely to metastasize–easier to remove
diffuse–infiltrate surrounding brain tissues. 3 types: low grade, intermediate grade(anaplastic), glioblastomas
Low grade astrocytomas
slowest growing age 30-40 frontal lobe in adults(cerebrum=personality changes) cerebellum in children unilateral headaches easy to remove=better survival rates surgery, radiation, chemo
intermediate grade (anaplastic) astrocytomas
grow at a moderate rate
glioblastomas
highly malignant, fastest growing most common malignant tumor in adults unilateral headache to general headache rapid progression of symptoms, seizures surgery, radiation, chemo, stereotactic radiosurgery
oligodendrogliomas (glioma)
tumors in myelin producing oligodendrocytes
~50% frontal lobe, ~50% parietal/temporal
slow growing but progressive- several years
40-60 y/o
chronic headaches, partial/general seizures
Ependymoma (glioma)
ependymal lining of ventricular system 4th ventricle--more in children central canal of spinal cord increased ICP BILATERAL headaches
Medulloblastoma (glioma)
primitve embryonic cells- pluripotent stem cells
rapid growth malignant tumor in cerebellum
20% of childhood brain tumors
hydrocephalus-4th ventricle compressions, inc. ICP
may metastasize to spinal cord or higher brain areas.
Meningioma
33% of all tumors
slow growing, well encapsulated
cells in dura mater or arachnoid
if the tumor compresses tissue hard/long enough= cell death
Pituitary Adenoma
benign epithelial tumor of the pituitary
compression of the optic chiasm= tunnel vision(temporal field deficit)
effects on hormone secretion, rare before puberty
3:1 females to males
Schwannoma
encapsulated neoplastic Schwann cells
8th CN (or any cranial nerve) = acoustic neuroma
symptoms: facial paralysis, deaf, balance
Primary CNS lymphoma
lymphocytes, 1% of all intracranial tumors
increased frequency in aids
60% in the cerebral hemisphere (also cerebellum and brainstem)
changes in behavior, personality, confusion, dizziness
enlarged lymph nodes, fever, night sweats, unexplained weight loss, fatigue
secondary tumors are also called:
metastatic tumors
secondary tumors details
spread to the CNS from outside the brain. blood-brain barrier “somewhat” protects from metastasis
metastatic brain tumor origins(2ndary)
from malignancy outside CNS that spreads to brain through arterial circulatory system
1/3 start from lung cancer, then breast cancer, skin, GI, kidneys in that order
Metastatic brain tumor (2ndary) symptoms
- Headache-same side as tumor- that interrupts sleep and is worse upon waking (red flag)
- with nausea and vomiting, papilledema, focal signs, elicited by postural changes, coughing, or exercise
- May be due to local swelling, distortion of blood vessels, invasion of meninges, and/or increased ICP(causes drowsiness and decreased levels of consciousness to potential coma)
- Also seizures, cognitive and personality changes
- -Altered mental status (May start as subtle changes in concentration, memory, affect, personality, initiative, and/or abstract reasoning-May progress to severe cognitive problems and confusion)
Focal signs
frontal lobe, occipital, temporal,. cerebellum(sxs from damage to these lobes) +
Brainstem-Reticular formation (consciousness and attention), Vital functions associated with cardiovascular and respiratory systems > death
Can be associated with gait disturbances, diplopia, weakness, headache, vomiting, facial numbness and weakness and personality changes
Pituitary glands–Tumors here are typically large
Compress the pituitary gland and causes pituitary disorders: Cushing disease, hypothyroidism, Addison disease, diabetes
Papilledema
swelling of the optic nerve
Metastatic brain tumor (2ndary) interventions
Intervention: corticosteroids, brain irradiation, surgery, and/or chemotherapy
Rating of disability of function scale
Karnofsky Performance Scale
