Neurology 11 - Brain Tumours

Question 1

frontal lobe tumour possible presentation

Answer 1

unusual change in personality and behaviour

Question 2

4 causes of raised ICP

Answer 2

brain tumour
brain bleed
idiopathic intracranial HTN
abscesses, infection

Question 3

presentation of brain tumours

Answer 3

concerning headaches
altered mental state
visual field deficits
seizures
unilateral ptosis 
third/sixth nerve palsies
papilloedema

Question 4

5 concerning features of headaches

Answer 4

vomiting 
worse on coughing, straining, leaning forward
worse on waking
nocturnal headache
constantly there

Question 5

6 signs of papilloedema (i.e. raised ICP) on fundoscopy

Answer 5

blurring of disc margin
elevated optic disc distorting vessels
loss of venous pulsation
engorged retinal veins
bleeds around optic disc
Paton's lines (creases in retina around optic disc)

Question 6

4 most common organ primaries that metastasise to the brain

Answer 6

lung
brain
colorectal
prostate

Question 7

3 types of glioma

Answer 7

worst to best:
astrocytoma (mostly glioblastoma multiforme)
oligodrendoglioma
ependymoma

Question 8

meningioma

Answer 8

usually benign but may create pressure symptoms

Question 9

consider pituitary tumour

Answer 9

bitemporal hemianopia

signs of hormone deficiency or excess

Question 10

acoustic neuroma

Answer 10

tumour of Schwann cells surrounding auditory nerve , occur around the CPA

unilateral unless NF2

Question 11

classic triad of acoustic neuroma

Answer 11

hearing loss
tinnitus
balance problems

can also see facial nerve palsy at same time

Question 12

treating pituitary tumours

Answer 12

trans sphenoidal surgery
radiotherapy
bromocriptine if secrete prolactin
somatostatin analogues if secrete growth hormone