Multisite Disorders Flashcards
Rehabilitation for individuals with brain tumors
- individuals have shown progress in the rehabilitation setting
- Advances in medical and surgical interventions have improved survival rates and is associated with longer life expectancy
Goals of rehab
Improve body structure & function, activity & participation limitations
Improve quality of life
Opportunity to return to home
Takes an interdisciplinary team
Incidence and Etiology
-more tumors are being diagnosed (improved tumor imaging), rather than true increase in occurrence
-Bimodal distribution
Children: 0 – 15 years
Adults: 50-70 years
Etiology
- runs in family is questionable
- common toxic environment or infectious exposure
- association with certain chemicals
Primary brain tumors
- Originate in the CNS
- Primary CNS tumors typically do not metastasize
- Lack of lymphatic system in CNS to transport cancerous cells
Secondary or metastatic tumors
- Spread to the CNS from systemic sites outside of the brain
- **Blood-brain barrier “somewhat” protects the brain from metastasis
Primary tumors
- Gliomas - Four primary categories
- -Astrocytomas
- -Oligodendrogliomas
- -Ependymomas
- -Medulloblastomas
- Meningiomas
- Pituitary adenomas
- Schwannomas
- Primary CNS lymphomas
Gliomas
-Arise from glial cells
-42% of all brain tumors
-Frequently located in the cerebral hemispheres
-Also occurs in the brain stem, optic nerve, and spinal cord
-Malignant tumors are more common after age 75
Benign forms are more common in children
- Astrocytomas
- Derived from astrocytes
- 35% of all brain tumors
- Most common primary brain tumor
- Morphology
- -Circumscribed (“contained”) – less likely of metastasis [easier to remove]
- -Diffuse – infiltrate surrounding brain structures
- Low-grade astrocytomas: slowest growing
- Intermediate-grade astrocytomas, or anaplastic astrocytomas, grow at a moderate rate
- Frequently found in the frontal lobes of adults and the cerebellum in children
- Intervention: Sx, radiation therapy, chemo
Low-Grade Astrocytomas
- Slowest growing of all CNS neoplasms
- Occurs in 3rd and 4th decades of life
- Typically located in the cerebrum
- -Frontal lobes especially
- Characterized by unilateral headaches
- Tend to see personality changes secondary to frontal lobe damage
- Frequently easy to surgically remove- result in better survival rates
Astrocytomas: Glioblastomas
-Glioblastoma Multiforme: Highly malignant grade IV astrocytoma
-Glioblastomas are the fastest growing
Most common malignant brain tumor in adults
-1st symptom is typically a unilateral headache followed by a generalized headache
-Rapid progression of symptoms
-May have seizures
-Intervention: Surgical resection, radiation therapy, stereotactic radiosurgery & chemo
- Oligodendroglioma
- Slow-growing, but progressive tumors that develop over several years
- Tumors in the myelin-producing oligodendrocytes
- ~ 50 % in the frontal lobe
- ~ 50% in the temporal or parietal lobes
- Occurs in adults (40-60 YO)
- Characterized by:
- -Chronic headaches
- -History of partial or generalized seizures
- Ependymoma
- Affects the ependymal lining of the ventricular system
- Can also affect the central canal of the spinal cord
- Common site is 4th ventricle: More prevalent in children
- Get signs/symptoms of increased ICP (e.g. headaches)
- Medulloblastoma
- Arise from primitive embryonic cells
- Rapidly growing, malignant tumor of the cerebellum
- Hydrocephalus is common (4th ventricle compression: Increased ICP
- May metastasize to the spinal cord & higher brain areas
Meningiomas
- Slow growing CNS tumors
- Originate from cells in the dura mater or arachnoid membrane
- 33% of all brain tumors
- Also spinal tumors
- Majority are benign
- Most are well-encapsulated tumors
- Resectable tumors are primarily treated with surgery
