Neuro-Oncology Flashcards
The cerebrum is derived embryologically from which structure?
Telencephalon
What is the dominant cerebral hemisphere in the majority of people?
Left
What are the lobes of the cerebral hemispheres?
Frontal Parietal Temporal Occipital Insular Limbic
What four important gyri are contained within the frontal lobe?
Precentral gyrus
Superior frontal
Middle frontal
Inferior frontal
What is contained within the precentral gyrus?
Primary motor area
What is contained within the middle frontal gyrus?
Frontal eye fields (control voluntary eye movement)
What is contained within the inferior frontal gyrus?
Broca’s area (in dominant hemisphere)
Damage to Broca’s area causes what features?
Expressive dysphasia (patient comprehends words but cannot speak properly)
The postcentral gyrus is found in the temporal lobe. True/false?
False - parietal
What is contained within the postcentral gyrus?
Primary somatosensory area
What lobules are found in the parietal lobe?
Superior parietal lobule
Inferior parietal lobule
What is contained within the inferior parietal lobule?
Supramarginal and angular gyri
Damage to the supramarginal and angular gyri causes what clinical feature?
Nominal aphasia (problems recalling words/names/numbers)
What gyri are contained within the temporal lobe?
Superior temporal gyrus
Middle temporal gyrus
Inferior temporal gyrus
What is contained within the superior temporal gyrus?
Auditory cortex
Wernicke’s speech area (dominate hemisphere)
Damage to Wernicke’s speech area causses what clinical feature?
Receptive dysphasia (impaired comprehension and produces jargon)
What is contained within the occipital lobe?
Visual cortex
Where are the limbic structures located?
Medial hemisphere surface that encircles corpus callosum
What are the functions of the limbic system?
Emotional function
Memory
Give some structures found in the limbic system
Cingulate gyrus
Hippocampus
Amygdala
Hypothalamus
The cerebellum is derived embryologically from which structure?
Metencephalon
What seperates the cerebrum and cerebellum?
Tentorium cerebelli
What connects the right and left hemispheres of the cerebellum?
Vermis
What are the three components of the cerebellum?
Vestibulocerebellum
Spinocerebellum
Cerebrocerebellum
Give some functions of the vestibulocerebellum
Maintaining balance
Coordinating vestibular-ocular reflexes
Give some functions of the spinocerebellum
Maintain tone
Posture and gait
Give some functions of the cerebrocerebellum
Coordinating voluntary motor activity
The diencephalon is the embryological origin of which structures?
Thalamus
Hypothalamus
Subthalamus
Epithalamus
Give some of the functions of thalamic nuclei
Maintaining consciousness
Modulating motor function
Cutaneous and visceral sensory receptors
What three systems are influenced by the hypothalamus?
Autonomic nervous
Endocrine
Limbic
What are the structures of the basal ganglia?
Caudate nucleus
Putamen
Globus pallidus
What action are the basal ganglia involved in?
Initiating and facilitating movement
Inhibiting motor cortex
How do CNS tumours tend to present?
Focal neurological deficits Headaches Seizures Cognitive slowing Personality changing Endocrine disturbances
How may patients with a frontal lobe tumour present?
Contralateral weakness
Personality changes
Expressive dysphasia
Urinary incontinence
How may patients with a temporal lobe tumour present?
Memory deficits
Receptive aphasia
Contralateral superior quadrantopia
How may patients with a parietal lobe tumour present?
Contralateral weakness and sensory loss
Contralateral inferior quadrantopia
Dyscalculia/dysgraphia
How may patients with an occipital lobe tumour present?
Contralateral homonymous hemianopia
Visual hallucinations
How may patients with a cerebellar tumour present?
Ataxia N+V Dizziness and vertigo Slurred speech Intention tremor
What is the most common primary brain tumour?
High grade glioma (grade III/IV)
What is a grade III glioma called?
Anaplastic astrocytoma
What is a grade IV glioma called?
Glioblastoma multiforme
What imaging is used to detect GBM? How does it appear?
MRI
Butterfly appearance
If MRI suggests high grade glioma what must occur?
Biopsy of tumour
How are GBMs treated?
Surgery + radiotherapy +/- chemotherapy
When are high grade and low grade gliomas most likely to occur?
High grade - 60-70
Low grade - 10-20
What is a grade I glioma called?
Pilocytic astrocytoma
Pilocytic astrocytomas have a high rate of remission. True/false?
True
Where do pilocytic astrocytomas most commonly occur?
Cerebellum Midline structures (thalamus/optic chiasm)
Where do diffuse astrocytomas tend to grow?
Frontal and parietal lobes
How are diffuse astrocytomas treated?
Resective surgery + chemo/radiotherapy
Where do oligodendrogliomas tend to affect?
Frontal lobe
How do oligodendrogliomas tend to present?
Seizures
Headaches
Meningiomas originate from which cells?
Arachnoidal cap cells within arachnoid membrane
When are meningiomas commonest?
50-60s
Patients with which condition are more likely to develop meningiomas?
Neurofibromatosis type II
Acoustic neuromas are benign tumours derived from which cells?
Schwann cells
Bilateral acoustic neuromas is a sign of which condition?
Neurofibromatosis type II
How do acoustic neuromas present?
Unilateral sensorineural hearing loss Tinnitus Vertigo Headache Facial pain
How can vestibular schwannomas be managed?
Serial observation
Radiosurgery
Microsurgical excision
Where do haemangioblastomas develop?
Posterior fossa
Haemangioblastomas are most commonly associated with which condition?
Von-Hippel-Landau syndrome
