Intracranial Tumours

Question 1

Primary intracranial neoplasms are the 2nd most common tumours in children. True/False?

Answer 1

True

Question 2

List the typical clinical presentations/symptoms of intracranial neoplasms

Answer 2

Neurological deficit
Motor weakness
Headache
Seizures

Question 3

List clinical presentations/symptoms of raised intracranial pressure

Answer 3

Headache
Vomiting
Mental changes
Seizures
Visual impairment

Question 4

Neurological signs of tumours correlate with anatomical location and function. List the features associated with the frontal lobe

Answer 4

Thought
Reasoning
Behaviour
Memory
Movement

Question 5

Neurological signs of tumours correlate with anatomical location and function. List the features associated with the temporal lobe

Answer 5

Behaviour
Memory
Hearing and vision
Emotion

Question 6

Neurological signs of tumours correlate with anatomical location and function. List the features associated with the parietal lobe

Answer 6

Intellect
Thought
Reasoning
Memory

Question 7

Neurological signs of tumours correlate with anatomical location and function. List the features associated with the occipital lobe

Answer 7

Speech
Motor and sensory
Abstract concepts
Visual

Question 8

List all potential investigations that may be done for suspected intracranial neoplasms

Answer 8

CT
MRI +/- contrast
Lumbar puncture
PET scan
Lesion biopsy
EEG
Angiography
Radionucleotide study

Question 9

Describe WHO grade I astrocytic tumours

Answer 9

Pilocytic

Pleomorphic xanthoastrocytoma

Question 10

Describe WHO grade II astrocytic tumours

Answer 10

Low grade astrocytoma

Question 11

Describe WHO grade III astrocytic tumours

Answer 11

Anaplastic astrocytoma

Question 12

Describe WHO grade IV astrocytic tumours

Answer 12

Glioblastoma multiforme

Question 13

Who is typically affected by grade I astrocytic tumours?

Answer 13

Children
Young adults
Typically headache with vomiting and low appetite

Question 14

What is the treatment of choice for grade I astrocytic tumour?

Answer 14

Surgery (curative)

Question 15

Grade II astrocytic tumours (low grade astrocytoma) have predilection for which brain lobes?

Answer 15

Temporal
Frontal
Parietal

Question 16

List poor prognostic factors for low grade astrocytomas

Answer 16

Age over 50
Focal deficit
Short duration of symptoms
Raised ICP
Altered consciousness

Question 17

Outline treatment options for low grade astrocytomas

Answer 17

Radio/chemo -therapy

Surgery

Question 18

Which carries poorer prognosis - anaplastic astrocytoma or glioblastoma multiforme?

Answer 18

Glioblastoma multiforme (1 year)
Anaplastic astrocytoma (2 years)

Question 19

List some chemotherapy agents that may be used for astrocytic tumours

Answer 19

Temozolamide (CA inhibitor)
Procarbazine
Carmustine wafers

Question 20

Which lobe do oligodendroglial tumours predominately affect?

Answer 20

Frontal lobe

Question 21

Describe the morphology of oligodendroglial tumours (buzzword)

Answer 21

Grayish-pink

Toothpaste-like

Question 22

What is median survival for oligodendroglial tumours?

Answer 22

10 years

Question 23

What % of intracranial tumours are meningiomas?

Answer 23

20%

Question 24

Majority of meningiomas are asymptomatic. True/False?

Answer 24

True

Question 25

What is meningioma en plaque?

Answer 25

Subtype of meningiomas that infiltrate dura and sometimes bone
Carpet/sheet-like lesions

Question 26

Meningiomas are usually malignant. True/False?

Answer 26

False
Histologically benign (90%)

Question 27

Outline treatment of meningioma

Answer 27

Pre-operative embolization

Surgery

Question 28

What do pineal tumours typically obstruct?

Answer 28

CSF outflow, leading to hydrocephalus