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Neurology SB > Intracranial Neoplasms > Flashcards

Intracranial Neoplasms Flashcards

1
Q

what is an extra-axial tumour

A

lesions that are external to the brain parenchyma

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2
Q

what is the most common type of extra-axial tumour

A

meningioma

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3
Q

what are features of meningioma tumours

A

usually benign tumors that arise from residual mesenchymal cells in the meninges

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4
Q

what are other extra-axial tumours

A

pituitary adenoma
craniopharyngioma
choroid plexis papilloma
acoustic neuroma (vestibular schwannoma)

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5
Q

what is a key fact about epidemiology of primary brain tumours

A

2nd most common seen in children

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6
Q

what are common Sx of a presentation of tumour

A 
progressive neurological deficit
motor weakness
headache
seizure
vomiting 
mental changes
papilloedema
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7
Q

what is headaches, vomiting, mental changes and seizures a sign of

A

increased ICP

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8
Q

what does blockage of CSF flow lead to

A

hydrocephalus

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9
Q

headache can only occur with raised ICP - true or false

A

false

can occur without raised ICP

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10
Q

what are worrying features of a headache

A 
worse in morning; wakes them up
worse on lying down
worse with coughing/leaning forward 
worse on walking
associated with vomiting
gets better with vomiting
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11
Q

what do neurological signs depend on

A

tumour location

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12
Q

what is the frontal lobe responsible for

A

thought
reasoning
behaviour
memory

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13
Q

what is pre central gyrus responsible for

A

movement

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14
Q

what is post central gyrus responsible for

A

sensory

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15
Q

what is the temporal love responsible for

A

behaviour
memory
hearing & vision pathways
emotion

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16
Q

what is the parietal lobe responsible for

A

intellect
thought
reasoning
memory

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17
Q

what are the types of neuroepithelial tissue

A 
Astrocytes
Oligodendroglial cells
Ependymal cells/ choroid plexus
Neuronal cells
Pineal cells
Embryonic
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18
Q

what are the 4 gradings of astrocytic tumours

A

I - Pilocytic astrocytoma

II - Diffuse/Low grade astrocytoma

III - Anaplastic astrocytoma

IV- Glioblastoma

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19
Q

what are features of grade I astrocytomas

A

truly benign

slow growing

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20
Q

who commonly gets a grade I astrocytoma

A

children

young adults

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21
Q

what is the most common type of a grade I astrocytoma

A

pilocytic astrocytoma

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22
Q

what areas of the brain are pilocytic astrocytomas seen

A

optic nerve
hypothalamic gliomas
cerebellum
brainstem

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23
Q

Tx option for pilocytic astrocytoma

A

surgery

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24
Q

what are the sub types of Grade II astrocytomas (low grade)

A 
fibrillary astrocytoma (most common)
protoplasmic astrocytoma, gemistrocytic astrocytoma.
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25
Q

where do low grade astrocytomas often affect

A

temporal lobe

posterior frontal lobe anterior parietal lobe

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26
Q

where are the peak incidence for grade II astrocytomas

A

20-45y/o and 6-12y/o

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27
Q

what is the common presentation of grade II astrocytomas

A

seizures

headaches

28
Q

what are poor prognostic factors for grade II astrocytomas

A
  • age >50
  • focal deficit (e.g. seizures)
  • short duration of symptoms
  • raised ICP
  • altered consciousness
  • enhancement on contrast studies
29
Q

Tx for grade II astrocytoma

A

surgery +/- radiation

30
Q

what is the median survival for anaplastic astrocytomas/grade III

A

2 years

31
Q

when do grade III tumours commonly occur

A

40-50 y.o

older than low grade astrocytoma and younger than glioblastoma

32
Q

anaplastic astrocytomas can progress into glioblastoma - true or false

A

true

33
Q

what is the most common adult primary intracranial tumour

A

Glioblastoma multiforme

34
Q

when is the peak age for a grade IV/glioblastoma

A

65-75 y/o

35
Q

what is Glioblastoma multiforme associated with

A

NF type I

Turcot Syndrome

36
Q

how does Glioblastoma multiforme spread

A

via white matter tracking/CSF pathways

particularly the corticospinal tract and corpus callosum

37
Q

what is the corpus callosum

A

links the cerebral cortex of the left and right cerebral hemisphere

38
Q

what is a glioma spreading to the callosum sometimes called

A

butterfly glioma”

39
Q

1st line treatment of grade IV

A

surgery +/- chemo or radiotherapy

40
Q

what are the 2 most common forms of glial tumours

A

Astrocytomas

Oligodendroglial tumours

41
Q

what is the epidemiology of oligodendroglial tumours

A
  • another type of glial tumour
  • less common and account for 20% of glial tumours
  • seen at age 25-45y/o and 6-12y/o
42
Q

where do oligodendroglial tumours commonly affect

A

the frontal lobe

43
Q

how to oligodendroglial tumours appear

A

greyish-pink

44
Q

how are subarachnoid accumulations in oligodendroglial tumours described as looking

A

toothpaste morphology

45
Q

what can help pathologist distinguish oligodendroglial tumours from astrocytomas

A

oligodendroglial tumours have:

  • cysts
  • peripheral calcification
  • peritumoural haemorrhage
46
Q

what are collision tumours

A

mix of oligodendroglial cells and astrocytic cells

47
Q

what is the first line treatment for oligodendroglial tumours

A

Chemotherapy

are very chemosensitive

48
Q

what can meningiomas originate from

A

arachnoid cap cells of the meninges

49
Q

what are features of meningiomas

A
  • most common extra-axial tumour
  • usually benign
  • rarely malignant or invade brain tissue
  • produce Sx by compressing underling brain
50
Q

what are meningiomas associated with

A

breast cancer

NF II

51
Q

what are the 2 macroscopic forms of meningioma

A

globuse

meningioma en plaque

52
Q

how do globuse meningioma apprear

A

rounded, well defined dural masses, looks like a fried egg (most common presentation)

53
Q

how do meningioma en plaque appear

A

carpet or sheet-like lesions that infiltrate the dura and invade the bone with extensive regions of dural thickening.

54
Q

where are common locations for meningiomas

A

parasagittal, convexity, sphenoid, intra-ventricular

55
Q

what Sx might be seen in meningiomas

A

headaches
cranial nerve neuropathies
paresis
change in mental status

majority are asymptomatic

56
Q

what is 1st Ix for meningioma

A

MRI head

57
Q

what are the types of nerve sheath tumours

A

Vestibular Schwannomas
Neurofibromas
Malignant peripheral nerve sheath tumours (MPST)

58
Q

where are Vestibular Schwannomas commonly seen

A

Cerebellopontine angle.

59
Q

what causes Vestibular Schwannomas/acoustic neuromas

A

benign tumour of schwann cells in the vestibular portion of CN VII

60
Q

what should be suspected in bilateral Vestibular Schwannomas/acoustic neuromas

A

NF type II

61
Q

what reflex is loss in Vestibular Schwannomas/acoustic neuromas

A

corneal reflex

62
Q

Sx of Vestibular Schwannomas/acoustic neuromas

A 
hearing loss; asymmetrical commonly; (SNHL)
dizziness
facial numbness
tinnitus
loss of equilibrium
63
Q

Ix of Vestibular Schwannomas/acoustic neuromas

A

1st - audiogram

2nd - contrast MRI

64
Q

Tx of Vestibular Schwannomas/acoustic neuromas

A

1 - focused radiation or surgery

65
Q

what is the most common germ cell tumour

A

germinomas

Neurology SB (23 decks)

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