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Neurology Module > Neoplasms of the Brain > Flashcards

Neoplasms of the Brain Flashcards

1
Q

Prevalence of Primary Brain Tumors

A

2% of all cancers

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2
Q

Peak incidence of Primary brain tumors

A

65-79

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3
Q

Men vs Women for Brain tumors

A

Men > Women for most tumors.

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4
Q

Risk factors for Brain Tumors

A

High dose ionizing radiation.

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5
Q

Signs and Symptoms of Brain Tumors

A 
Headaches
Seizures
Congitive/Personality Changes
Focal Weakness
N/V
Speech Difficulty
Visual Changes
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6
Q

PE findings for Brain Tumor

A

Papilledema
CN6 Palsy
Motor Exam
Gait disturbance

-Depends on brain tumor location.

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7
Q

Benign Brain Tumors

A

Meningioma (30%)
Pituitary Adenoma (5-10%)
Schwannoma (3-5%)
Craniopharyngioma (<2%)

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8
Q

Most common benign brain tumor

A

Meningioma

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9
Q

Malignant Brain Tumors

A 
Gliomas
Astrocytoma (18-20%)
Glioblastoma (35-40%)
Oligodendroglioma
Pineal tumor (2%)
Medulloblastoma (<1%)
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10
Q

Most common malignant brain tumor

A

Glioblastomas

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11
Q

“Other” Types of Brain Tumors

A

neurofibromatosis

metastatic tumors

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12
Q

Most common Pediatric Brain Tumors

A

Medulloblastoma

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13
Q

What are the most solid tumors in children?

A

Brain tumors

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14
Q

Brain tumor types in children

A 
Astrocytoma
Brain stem gliomas
Ependyoma
Craniopharyngioma
\+/- others
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15
Q

Most common type of brain tumor

A

Meningioma

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16
Q

Meningioma Women v Men

A

3:1

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17
Q

Where do meningiomas come from?

A

Arise from the meninges in the arachnoid space

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18
Q

What may be a problem with a meningioma in the intraventricular sinus?

A

Hydrocephalus

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19
Q

Which meningiomas are more difficult to remove?

A

Those in the base of the skull.

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20
Q

What problem would a meningioma in teh posterior fossa cause?

A

Cranial Nerve Palsies and issues

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21
Q

Diagnosis of Meningiomas

A

Distinct radiological characteristics

  • “dura tail”
  • Indentation of brain
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22
Q

Meningioma Grading

A

Grade I: Meningioma (85%)- benign

Grade II: Atypical meningioma (15%)
Neither cancerous, nor benign
Grow faster, recur

Grade III: Anaplastic meningioma (1-4%)
Malignant
Invasive

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23
Q

Benign Meningioma

A

Grade I

85%

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24
Q

Atypical Meningioma

A

Grade II
15%

Neither cancerous, nor benign
Grow faster, recur

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25
Anaplastic Meningioma
Grade III 1-4% Malignant Invasive
26
Treatment of Meningioma
Watchful waiting Craniotomy - Remove as much of the tumor as possible - Location and size are factors Radiation - Sterotactic radiation - “stereotactic radiosurgery” - “gamma knife”
27
Familial Link of Pituitary Adenomas
Familial link- multiple endocrine neoplasia type 1 (MEN1)
28
Pituitary adenomas account for _____% of tumors
10
29
Presentation of pituitary adenomas depends on
type of cell abnormality
30
Signs and Symptoms of Prolactinoma
``` Lactotrophs Gallactorrhea, gynecomastia Suppression of LH: Women: infertility, amenorrhea Men: ED ```
31
Most common pituitary adenoma.
Prolactinoma
32
S/S Growth Hormone
Somatotrophs | Acromegaly
33
S/S Nonfunctioning adenoma
No hormonal abnormalities | Compresses optic nerve
34
S/S Adrenocorticotropin Hormone (ACTH)
corticotrophs | Cushing’s
35
S/S LS/FSH pitutiary adenoma
gonadotrophs
36
TSH Pituitary Adenoma
thyrotrophs Increased TSH Secondary Hyperthyroidism
37
Pituitary Adenoma classified by
Size
38
Pituitary Adenoma > or = 10 mm
Macroadenoma
39
Pituitary Adenoma <10 mm
Microadenoma
40
Treatment/Management of Pituitary Adenoma
Consult: Endocrinology and Neurosurgery Nonfunctioning: ophthalmology Medical management Surgical approach: Minimally invasive endonasal endoscopic surgery If surgery not option or recurrence: Stereotactic- these tumors do not respond quickly to radiation and may take months to control
41
Craniopharyngiomas occur near
the pituiatary gland.
42
Craniopharyngiomas are classified as
a pituitary tumor
43
How do Craniopharyngiomas differ from pituitary adenomas?
Adenomas arise from cells in the anterior lobe Craniopharyngiomas arrive from cells in Rathke’s duct Craniopharyngiomas have bimodal peak- ages 5-14 and 65-74
44
S/S Craniopharyngiomas
May disrupt pituitary function Optic nerve compression Increased ICP
45
Treatment of Craniopharyngioma
same as pituitary adenoma except usually subtotal excision + radiation (recurrence rate 15%)
46
Peak age of Schannoma - Acoustic Neuroma
30-60
47
Acoustic Neuroma occur on CN
CN VIII - Vestibulocochlear
48
Characteristics of Schwannoma - Acoustic Neuroma
Benign but can cause serious, life threatening complications rarely (brain stem compression, hydrocephalus)
49
Symptoms of Schwannoma-Acoustic Neuroma
Usually unilateral (except in neurofibromatosis2) Hearing loss- unilateral Tinnitus x 1 month or longer Vertigo- episodic Weber’s Test - lateralizes to good ear. Rinne- BC>AC
50
Imaging of Schwannoma-Acoustic Neuroma
MRI with attention to internal auditory canals
51
Treatment of Schwannoma-Acoustic Neuroma
Surgery: Keyhole surgery: Retromastoid/retrosigmoid craniotomy Minimizes risk of damage to cranial nerve and preservation of hearing
52
Malignancies arising from glial cells.
Gliomas
53
Glial Cells Include
Astrocytes Oligodendrocytes Ependymal
54
Functions of Astrocytes
Communicate with neurons Supportive- nutrients Blood brain barrier
55
Functions of Oligodendrocytes
Wrap around axons | Myelinate
56
Functions of Ependymal
Line Ventricles | Produce/Absorb CSF
57
Types of Glial Cell Malignancies/Gliomas
``` Astrocytoma Brainstem glioma Ependymoma Mixed glioma Oligodendroglioma Optic nerve glioma ```
58
Most common type of malignancy
Astrocytoma
59
Grading of Astrocytoma
Grade I: Pilocytic (2%) (considered benign) Grade II: Low Grade (8%) (considered benign) Grade III: Anaplastic (20%) Grade IV: Glioblastoma multiforme (70%)
60
Most inactive astrocytoma
Grade I - Pilocytic
61
If a pilocytic astrocytoma is disregarded it...
progresses to a higher grade.
62
Treatment of Pilocytic Astrocytoma
Surgical removal | Monitor

Neurology Module (7 decks)

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