Neuro-Oncology Flashcards by Meg Heil

What is a brain tumor

An abnormal growth of tissue that results from excessive cell division

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mass of cells that do not have the characteristic appearance of cancer

benign tumor

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Brain tumor containing cancer cells

malignant brain tumor

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do malignant tumors grow rapidly

yes

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Do malignant tumors have clear borders

yes

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malignant tumors can interfere with vital functions and be life threatening

yes

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what is the median age for brain tumors

60 years old

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brain tumors are the ____ most common cancer among children

2nd

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WHO classification system

universal classification system
classifies tumor according to microscopic characteristics

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least malignant
possibly curable via surgery
non-infiltrated
long term survival
slow growing

grade 1

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relatively slow growing
somewhat infiltrative
may recur as higher grade

grade 2

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malignant
infilrative
tend to recur as higher grad

grade 3

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most malignant
rapid growth aggressive
widely infiltrative
rapid recurrence
necrosis prone

grade 4

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astrocytes

cells that make up the glue-like or supportive tissue of the brain

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grade 1
form sacs of fluid
slow growing
stay in one area
common in children

pilocytic astrocytoma

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treatment for pilocytic astrocytoma

surgery to remove, radiation if it cannot be removed

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grade 2
tend to invade surrounding tissue and grow at slow rate
contain microcytes or mucous like fluid
common in males>females and >45 years old

low grade astrocytoma

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treatment for low grade astrocytoma

surgery to remove radiation if it cannot be removed

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grade 3
tentacle like projections
found in males>female >45

anaplastic astrocytoma

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treatment for anaplastic astrocytoma

surgery and radiation or chemo

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grade 4
most common and deadliest malignant primary brain tumor
develops in cerebral hemispheres

glioblastoma multiforme

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glioblastomas can form from low grade ______ or oligodendroglia

astrocytoma

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what is the median survival rate for glioblastoma multiforme

8 months

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what is treatment for glioblastoma

surgery standard treatment
radiation
chemo
medical device- delivers electric tumor-treating fields to brain and physically break up tumor cell membranes

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usually grow inward causing pressure on brain most are benign and slow growing

meningiomas

what are the 3 types of meningiomas

1. benign meningioma- 88% 2. atypical meningioma- 15-20% 3. anaplastic meningioma- 1-4%

are meningiomas more common in men or women

women

Treatment for meningiomas

surgery and radiaiton

a metastatic or secondary brain tumor is formed by cancer cells from a _________

primary cancer elsewhere in the body

Where do typical metastatic tumors originate from

lung breast melanoma colon kidney

What are the signs and symptoms of a brain tumor

increased intracranial pressure seizure altered mental state focal neurological signs

headache nausea vomiting decreased level of consciousness 6th nerve palsy

increased intracranial pressure

present in 1/3 of all cases usually focal

seizures

invade the spinal cord may span several cord segments

intradural- intrameduallary

derived from supporting elements: meninges, nerve sheath cause spinal cord compression

primary intraspinal tumors

in metastatic tumors what if you see any oft the following signs -spinal pain -strength/sensory loss -bowel/bladder function loss

red flags

acts as a pro drug and needs to be transformed to its active form by the bodys metabolism

temodar

inhibits human vascular endothelial growth factor VEGF is a growth factor that leads to new blood vessel formation

avastin

side effects of chemo

destroys all rapid growing cells hair follicles cells of digestive tract blood cells needed to fight infections

Chemotherapy durg effects

peripheral neuropathy paresthesias malaise dizziness myelosuppresant muscle weakness

delivery of high dose ionizing radiation in a single fraction to a small precisely defined volume of tissue.

stereotactic radiosurgery

wearable portable FDA approved device indicated to treat a type of bran cancer called glioblastoma multiform in adults 22 years and older

optune device

for tumor resection or for biopsy mandatory in large tumors presenting with icp problems

craniotomy

side effects of craniotomy

extended hospital stay infection seeizure disorder dvt pe

minimally invasive brain surgery techniques

endoscopic endonasal approach

what are the for corridors that divide the cranial base

1. transcribriform 2. transplanum 3. transphenoidal 4. transclival

potential complication of brain surgery

1. incomplete lesion resection 2. neurological damage 3. infection 4. blood clots 5. bleeding 6. post op pain 7. CSF leak

too large attached to blood vessels attached to vital structures

incomplete lesion resection

may be temp or permanent -paralysis, weakness, numbness, spasticity -visual hearing disturbances -personality changes -loss of sexual function -coma hormonal imbalanes

neurological damage

fever chills, abdominal pain, redness, swelling, tenderness

infection

leg swelling, calf tenderness, chest pain/SOB

blood clots

always a risk of surgery tarry stool, fatigue, chest pain and sob

bleeding

clear drainage from nose/ear or down throat, HA, Fever

CSF leak

encourage mobilization what day post op

EEA precautions

log roll no bending no valsalva

educate on precautions

prevent increased pressure in head no bending/lowering head below waist no valsalva no straws no nose blowing no lifting no sports

minimally invasive for removing deep brain tumors

neuroendoport

what types of tumors can be removed by a neuroendoport

brain tumor ventricular tumor gliomas cancer metastases

what are the benefits of a neuroendoport

minimally invasive fewer side effects decreased scarring faster recovery

arise on CN8

acoustic neuroma

RMC approach

incision made behind ear with acess to angle preservation of hearing and facial nerves

retromastoid craniotomy with microvascular decompression

relieves abnormal compression of cranial nerve trigeminal neuralgia immediate relief majority of the time

PT after RMC

importance of ROM vestibular and balance screen of deficits

attenuate the deleterious effects of chemo and radiation low intensity 30-45% HRR RPE 1-3 2/3 sessions per week

phase 1

building a foundational base using functional and corrective training low intensity 40-60 HRR RPE 3-6 3 sessions per week

phase 2

improve physiological and psychological values beyond baseline. improvements in cv fitness, pulmonary function, muscular strength moderate to high intensity 60-85% RPE 4-8 3 sessions per week

phase 3

continue to improve progressions clients are apparently healthy 65-95% HRR RPE 6-10 3 or more sessions per week

phase 4