Intracranial pressure disorders

Question 1

Brain tumor : Types

Answer 1

1. Glioma : Glial cell tumors, surround and support neurons
* Astrocytoma } most common + malignant form

2. Meningiomas : tumor of cells from the meninges
* Benign
* Mass effect - Increasing IC pressure

3. Secondary metastases
* Lung, Breast, Renal, Melanoma

Question 2

Brain tumor : Clinical presentation

Answer 2

Increased IC pressure
1 . Chronic / Nocturnal Headache
* Worse on movement : walking, straining, bending forward
* Vomitting

2 . Papilloedema- swelling of optic disc
CSF pressure on optic nerve sheath, increases pressure around optic nerve
* Visual field defect, Ptosis, visual nerve palsy

Question 3

Brain tumor : Diagnosis

Answer 3

1. First line : MRI
2. Biopsy for Histology

Question 3

Pituitary tumors : Clinical features

Answer 3

1. Benign - excess growth may cause
   * __Bitemporal hemianopia_ - pressure on optic chiasm__
   * __Hypo/Hyper pituritarism__

Question 4

Pituitary tumors : Mx

Answer 4

• __Trans-sphenoidal surgery__ (through the nose and sphenoid bone)
• __Radiotherapy__

Question 4

diopathic intracranial hypertension : Definition

Answer 4

_1._ Neurological disorder characterized by __increased intracranial pressure without an identifiable cause.__

2. Likely secondary to impaired CSF absorption associated with hormonal changes from increased adipose tissue.

_3._ Classically seen in __young, overweight females__

Question 5

Idiopathic intracranial hypertension : Clinical features

Answer 5

classically seen in __young, overweight females__
1. Severe Headache - worse with movement
2. Sx of increased IC pressure
* Visual disturbances : blurred vision, diplopia, visual field defect
* Papilloedema : swelling of optic disc

Question 6

Idiopathic intracranial hypertension : Risk factors

Answer 6

1. Overweight women
2. Pregnancy
3. Drugs : COCP, Steroids, Retinoids

Question 7

Idiopathic intracranial hypertension : Mx

Answer 7

1. Weight loss
2. Carbonic anhydrase inhibitor (acetazolamide)
3. Topirimate
4. LP } acute sx relief
5. Surgery : IC Shunt