Intracranial Neoplasms Flashcards
in which patients are primary intracranial neoplasms more common in? (2)
adolescents
young adults
neoplasm that originates from dura mater or arachnoid and compress, rather than invade, surrounding tissue
meningioma
neoplasm that originates from normal glial cells
glioma
________ are the majority of primary tumors that arise within the brain parenchyma (tissue)
glioma
well-differentiated, not anaplastic, tend to be benign, and better prognosis
low-grade (I-II)
undifferentiated, anaplastic, malignant, and worse prognosis
high-grade (III-IV)
what are the 2 most common symptomatic brain neoplasm in adults?
glioma
meningioma
what is the most common primary malignant neoplasm in adults?
glioblastoma
what is the second leading cause of cancer death in children, after leukemia?
primary intracranial neoplasm
what are all S&S of primary intracranial neoplasms due to? (2)
disturbance of cerebral function
increased intracranial pressure
what are the 6 S&S of primary intracranial neoplasms?
headache
N/V
malaise
seizure
syncope
cognitive dysfunction
what is characteristic of headaches in primary intracranial neoplasms?
worsens with change in body position, coughing, sneezing, or valsalva
what symptom is most common in gliomas and cerebral metastases?
seizures
what causes syncope in intracranial neoplasms?
elevation of ICP temporarily cuts off cerebral blood supply
what are 4 things we will see in a patient’s physical exam?
weakness
sensory loss
aphasia
apraxia
what complication can occur that is associated with masses and their increased ICP?
brain herniation
what is the most common brain herniation?
temporal lobe herniation
a patient has ipsilateral pupil dilation, stupor, coma and respiratory arrest. what do they likely have?
temporal lobe herniation
a patient is experiencing apnea and circulatory collapse. what do they likely have?
herniation of cerebellar tonsils
in the case of an intracranial neoplasm, what is contraindicated and why?
lumbar puncture
can cause brain herniation
what is the major diagnostic modality for intracranial neoplasms?
neuroimaging
what is the imaging of choice?
gadolinium enhanced MRI
what diagnostic can be used to detect bone or vascular involvement?
CT
what diagnostic shows imaging of blood flow in tumors?
perfusion MRI
primary vs metastases. which is more common?
metastases
what are the 5 most common primary tumor locations in adults that metastasize to the brain?
melanoma
breast
lung
kidney
colorectal
what are the 3 most common primary tumor locations in children that metastasize to the brain?
sarcomas
neuroblastoma
germ cell tumors
what is the most common mechanism of metastases of neoplasms to the brain?
hematogenous spread
which area of the brain is metastases most common?
cerebral hemispheres
in which 3 cases would a patient need histology?
primary tumor doesn’t usually mets to brain
no known primary
neuroimaging not typical for mets
what diagnostic would give an accurate diagnosis?
histology
what will give a definitive diagnosis?
HE stain
exam of permanent tissue sections stained by hematoxylin and eosin
what is the treatment for stable asymptomatic meningiomas?
repeat imaging in 3-6 months
if stable, imaging annually
what are 2 treatment options for symptomatic meningiomas and asymptomatic tumors that are expanding, infiltrating, or associated with surrounding edema?
complete surgical resection
OR
partial resection + radiation
what is the treatment for malignant and atypical maningiomas?
resection
+
radiation therapy
what is the treatment for high-grade gliomas?
aggressive resection + radiation + chemo
what is the treatment/management for acoustic neuromas?
surgical resection +
radation +
MRI q 6-12 months
what can both improve symptoms and confirm diagnosis in all neoplasms?
partial resection
