Intracranial Neoplasms

Question 1

in which patients are primary intracranial neoplasms more common in? (2)

Answer 1

adolescents
young adults

Question 2

neoplasm that originates from dura mater or arachnoid and compress, rather than invade, surrounding tissue

Answer 2

meningioma

Question 3

neoplasm that originates from normal glial cells

Answer 3

glioma

Question 4

________ are the majority of primary tumors that arise within the brain parenchyma (tissue)

Answer 4

glioma

Question 5

well-differentiated, not anaplastic, tend to be benign, and better prognosis

Answer 5

low-grade (I-II)

Question 6

undifferentiated, anaplastic, malignant, and worse prognosis

Answer 6

high-grade (III-IV)

Question 7

what are the 2 most common symptomatic brain neoplasm in adults?

Answer 7

glioma
meningioma

Question 8

what is the most common primary malignant neoplasm in adults?

Answer 8

glioblastoma

Question 9

what is the second leading cause of cancer death in children, after leukemia?

Answer 9

primary intracranial neoplasm

Question 10

what are all S&S of primary intracranial neoplasms due to? (2)

Answer 10

disturbance of cerebral function
increased intracranial pressure

Question 11

what are the 6 S&S of primary intracranial neoplasms?

Answer 11

headache
N/V
malaise
seizure
syncope
cognitive dysfunction

Question 12

what is characteristic of headaches in primary intracranial neoplasms?

Answer 12

worsens with change in body position, coughing, sneezing, or valsalva

Question 13

what symptom is most common in gliomas and cerebral metastases?

Answer 13

seizures

Question 14

what causes syncope in intracranial neoplasms?

Answer 14

elevation of ICP temporarily cuts off cerebral blood supply

Question 15

what are 4 things we will see in a patient’s physical exam?

Answer 15

weakness
sensory loss
aphasia
apraxia

Question 16

what complication can occur that is associated with masses and their increased ICP?

Answer 16

brain herniation

Question 17

what is the most common brain herniation?

Answer 17

temporal lobe herniation

Question 18

a patient has ipsilateral pupil dilation, stupor, coma and respiratory arrest. what do they likely have?

Answer 18

temporal lobe herniation

Question 19

a patient is experiencing apnea and circulatory collapse. what do they likely have?

Answer 19

herniation of cerebellar tonsils

Question 20

in the case of an intracranial neoplasm, what is contraindicated and why?

Answer 20

lumbar puncture
can cause brain herniation

Question 21

what is the major diagnostic modality for intracranial neoplasms?

Answer 21

neuroimaging

Question 22

what is the imaging of choice?

Answer 22

gadolinium enhanced MRI

Question 23

what diagnostic can be used to detect bone or vascular involvement?

Answer 23

CT

Question 24

what diagnostic shows imaging of blood flow in tumors?

Answer 24

perfusion MRI

Question 25

primary vs metastases. which is more common?

Answer 25

metastases

Question 26

what are the 5 most common primary tumor locations in adults that metastasize to the brain?

Answer 26

melanoma breast lung kidney colorectal

Question 27

what are the 3 most common primary tumor locations in children that metastasize to the brain?

Answer 27

sarcomas neuroblastoma germ cell tumors

Question 28

what is the most common mechanism of metastases of neoplasms to the brain?

Answer 28

hematogenous spread

Question 29

which area of the brain is metastases most common?

Answer 29

cerebral hemispheres

Question 30

in which 3 cases would a patient need histology?

Answer 30

primary tumor doesn't usually mets to brain no known primary neuroimaging not typical for mets

Question 31

what diagnostic would give an accurate diagnosis?

Answer 31

histology

Question 32

what will give a definitive diagnosis?

Answer 32

HE stain exam of permanent tissue sections stained by hematoxylin and eosin

Question 33

what is the treatment for stable asymptomatic meningiomas?

Answer 33

repeat imaging in 3-6 months if stable, imaging annually

Question 34

what are 2 treatment options for symptomatic meningiomas and asymptomatic tumors that are expanding, infiltrating, or associated with surrounding edema?

Answer 34

**complete surgical resection** OR partial resection + radiation

Question 35

what is the treatment for malignant and atypical maningiomas?

Answer 35

resection + radiation therapy

Question 36

what is the treatment for high-grade gliomas?

Answer 36

aggressive resection + radiation + chemo

Question 37

what is the treatment/management for acoustic neuromas?

Answer 37

surgical resection + radation + MRI q 6-12 months

Question 38

what can **both** improve symptoms and confirm diagnosis in all neoplasms?

Answer 38

partial resection