Multi-site Conditions Flashcards
Brain Tumors and Cancer
What are the goals of rehab for those w/brain tumors
- improve body structure & function, activity and participation limitations
- Improve quality of life
- Opportunity to return home
- Takes an interdisciplinary team
What is the incidence of brain tumors in:
a) Adults
b) Children
a) 63,000 cases per year
b) 4,000 cases a year
What is the Etiology
- some heredity maybe/questionable
- causal effect, with certain chemicals, materials, and environments
What are primary brain tumors
Originate in the CNS and typically do not metastasize (no lymph system to transport the cancerous cells)
What are the secondary brain tumors
Metastasize to the CNS from sites outside of the brain, but the blood-brain barrier is somewhat protected from these
List the primary tumors
Gliomas Meningiomas Pituitary Adenomas Schwannomas Primary CNS lymphomas
What are the four types of Gliomas
Astrocytomas
Oligodendrogliomas
Ependymomas
Medulloblastomas
What type of brain tumors compose: 42% of all brain tumors 35% of all brain tumors 33% of all brain tumors 13% of all CNS tumors
Gliomas
Astrocytoma (sub of glial)
Meningiomas
Pituitary Adenomas
Where are gliomas located?
- Cerebral hemispheres
- Also: Optic nerve, BS, SC
What is the morphology behind astrocytomas?
- Circumscribed: less likelihood of metastasis
- Diffuse: Infrequently infiltrate surrounding brain structures
Low grade vs intermediate grade astrocytomas
Low-grade astrocytomas are the slowest growing vs intermediate are at a moderate rate
Where do you find astrocytomas?
- Frontal lobes: Adults
- Cerebellum: Children
What is a characteristic sign of a low-grade astrocytomas?
- Unilateral headaches
- Personality changes
T or F: It is easy to surgically remove a low-grade astrocytoma
True! and it results in better survival rates
List the types of astrocytomas
Low-grade astrocytoma
Intermediate grade astrocytoma
Glioblastomas
Which type of astrocytoma is the fastest growing?
Glioblastomas
T or F: Glioblastomas have a slow progression of symptoms
False, they have a rapid progression of symptoms
What is an oligodendroglioma?
A slow-growing, bur ptrogressive tumors that develop over several years in the myelin-producing dendrocytes in the frontal, temporal or parietal lobes
What are oligodendrogliomas characterized by?
- Chronic headaches
- History of partial or generalized seizures
What is an ependymoma?
- Affects the ependymal lining of the ventricular system (esp. 4th ventricle) and can also affect the central canal of the spinal cord
What are the s/s of ependymoma?
Increased ICP
What is a medulloblastoma?
Rapidly growing, malignant tumor of the cerebellum and that arise from primitive embryonic cells that may metastasize to the SC and higher brain areas
What is a common s/s of medulloblastoma?
Hydrocephalus of the 4th ventricle causing increased ICP
What is a meningioma?
A slow growing CNS tumors that originate from cells in dura or arachnoid membrane, where the majority are benign, well-encapsulated tumors
What is a pituitary adenoma
Benign epithelial tumors of the pituitary gland characterized by hyper- or hypo-secretion of hormones that is rare before puberty
Which type of tumors frequently encroach on the optic chiasm
Pituitary adenomas
What are schwannomas?
Encapsulated tumors composed of neoplastic Schwann cells that frequently involves the 8th CN, but can involve any cranial or spinal nerve
What is only 1% of all intracranial tumors?
Primary CNS lymphomas, but it is increased frequency in individuals with AIDS
What are the s/s of primary CNS lymphomas?
- Behaviour and personality changes
- Confusion
- Dizziness
- Enlarged lymph nodes
- Fever
- Night sweats
- Unintended weight loss
- Fatigue
What are metastatic brain tumors and order of origination
Originate from malignancies outside of the CNS: Lung Cancer Breast Skin GI Kidneys
What are the s/s of primary and secondary tumors
- headaches, seizures, cognitive and personality changes, and or focal signs
Headaches s/s
- start as dull, intermittent, and non-specific on the same side as the tumor
- Interrupt sleep or are worse upon waking and may improve throughout the day
- Nausea, vomiting, and papilledema associated
Seizures - stats
Present in 1/3 of cases
Cognitive and personality changes s/s
- altered mental status
- may start as subtle changes in concentration, meory, affect, personality, initiative, and or abstract reasoning
What is papilledema
Swelling of the optic nerve, less frequent due to improved diagnostic imaging
