Patho- SPace occupying lesions Flashcards by Finlay Strivens

What things can cause a space occupying lesion?

Bleeds
Tumour
Idiopathic intracranial hypertension
Hydrocephalus

How well did you know this?

Not at all

Perfectly

What types of bleed can cause a space occupying lesion?

Extradural
Subdural
SAH

How well did you know this?

Not at all

Perfectly

What can cause an extradural hematoma?

Trauma

How well did you know this?

Not at all

Perfectly

What can cause a subdural hematoma?

Ruptured bridging vein

How well did you know this?

Not at all

Perfectly

What can cause a SAH?

CoW rupture/Berry aneurysm

How well did you know this?

Not at all

Perfectly

What is the most common brain tumour?

Secondary mets

How well did you know this?

Not at all

Perfectly

What are the most common mets to the brain?

Breast
Bronchus
Malignant melenoma

How well did you know this?

Not at all

Perfectly

What are the two categories of primary brain tumour?

Extrinsic- Meninges

Intrinsic- Brain parenchyma

How well did you know this?

Not at all

Perfectly

Give an example of extrinsic brain tumours?

Meningioma

How well did you know this?

Not at all

Perfectly

From where does a meningioma normally occur?

Subarachnoid

How well did you know this?

Not at all

Perfectly

What are some symptoms of a meningioma?

Largely asymptomatic
Headache
CN neuropathy
Can erode bone

How well did you know this?

Not at all

Perfectly

How do you treat a meningioma?

CT/MRI- Homogenous, space-occupying lesion that densely enhances after contrast media
Leave
Surgery
Radio

How well did you know this?

Not at all

Perfectly

What is the most common form of intrinsic brain tumour?

Glioma

How well did you know this?

Not at all

Perfectly

What kind of cells do glioma arise from?

Glial cells

How well did you know this?

Not at all

Perfectly

Can gliomas metastase?

Yes but only to the brain

How well did you know this?

Not at all

Perfectly

What glial cells do gliomas tend to arise from?

Astrocytes

Oligoendrocytes

How well did you know this?

Not at all

Perfectly

What are the symptoms of an oligodendrocyte glioma?

Slow growing
Solid pink/grey
Frontal lobe
25-45YO
Seizures
Can become malignant
Calcifications

How well did you know this?

Not at all

Perfectly

How do you treat an oligodendrocyte glioma?

Surgery and chemo

How well did you know this?

Not at all

Perfectly

What are the four grades of an astrocytoma?

I- Benign
II- Start benign then transform
III/IV- Malignant then die in months

How well did you know this?

Not at all

Perfectly

What is an example of a grade I astrocytoma?

Pilocytic astrocytoma

How well did you know this?

Not at all

Perfectly

What is a Pilocytic astrocytoma?

Grade I astrocytoma

How well did you know this?

Not at all

Perfectly

Where do Pilocytic astrocytoma normally affect?

Optic nerve
Brain stem
Cerebellum

Give some examples of a grade II astrocytoma?

‘Low grade’ astrocytoma- Seizures
Fibrillary Astrocytoma- Surgery
Astrocytomas become Glioblastoma- Surgery

Give some examples of a stage III/IV astrocytoma

Anaplastic Astrocytoma

Glioblastoma multiforme

How do you treat an Anaplastic Astrocytoma?

No cure but surgery can help- radio post op

How do you treat Glioblastoma multiforme?

No cure but surgery can help- radio post op

How do gliomas tend to present?

Insidious onset of neuro deficits | Seizures

What is the differential for a glioma?

Stroke

How do you treat a glioma?

Image | Pallitate

What are some examples of nerve sheath tumour?

Schwannoma | Neurofibroma

What is the most common schwannoma?

Vestibular schwannoma

What are the symptoms of a vestibular schwannoma?

Progressive deafness Facial sensory loss Ipsilateral cerebral sign Hydrocephalus

How do you treat a vestibular schwannoma?

Hydrocephalus treatment Radio Surgery

How do you diagnose a schwannoma?

MRI

What are the general symptoms of a brain tumour?

``` Progressive neuro deficit Motor weakness Headache- wakes them up New seizures Changes in behavior Symptoms of increased ICP: N+V, Headache, Mental changes, Seizures ```

What are the direct effects of a brain mass?

Tissue destruction

What are the secondary effects of a brain mass?

Herniation | Raised ICP effects- papilloedema etc

What causes the secondary effects of a brain mass?

Raised ICP

What are some raised ICP effects?

Papilloedema | Non-communicating hydrocephalus

What are the forms of herniation possible in the brain?

Subfalcine/cingulate- cross midline Transtentorial/uncal herniation- Cerebral through tentorium Tonsillar- coning. Cerebellum down through foramen magnum.

What are some signs of tonsillar herniation?

Impaired consciousness Resp arrest Bradycardia Decerebrate posture- Arms and legs being held straight out, the toes being pointed downward and the head and neck being arched backwards.

How do you treat a brain mass?

``` No LP Mannitol + steroids- for oedema Antiepileptics Chemo not much help Surgery can help but is complicated ```

What must you not do with raised ICP?

Why must you not LP a raised ICP?

Coning risk

What is Idiopathic intracranial hypertension?

Hydrocephalus with no mass and no increase in ventricle size

Who tends to get Idiopathic intracranial hypertension?

Obese young women

WHat are some symptoms of Idiopathic intracranial hypertension?

Menstral irregularities Headache Blurred vision Papilloedema

How do you treat idiopathic intracranial hypertension?

Repeated LP Acetazolamide Thiazide diuretics Weight reduction

What generally causes hydrocephalus?

Obstruction of outflow leading to enlargement of ventricle

WHat are the main causes of hydrocephalus in infants?

Arnold-Chiari malformation | Cerebral aqueduct stenosis

What is the main cause of hydrocephalus in adults?

Cerebral aqueduct stenosis

What are some symptoms of hydrocephalus in adults?

``` Headache Cogitative impairment Vomiting Papilloedema Ataxia Bilateral signal ```

How do you treat hydrocephalus in adults?

Treat underlying cause | Shunt