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Nervous System > Pathology of Brain Tumours > Flashcards

Pathology of Brain Tumours Flashcards

1
Q

Flow always occurs down

A

a pressure gradient

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2
Q

Equation for cerebral perfusion pressure

A

CPP = MAP - ICP

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3
Q

Equation for cerebral blood flow

A

CBF = CPP/CVR
or
CBF = (MAP - ICP) / CVR

(CVR = cerebrovascular resistance)

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4
Q

Ischaemia causing raised ICP will result in

A

increased MAP, to ensure CPP is maintained

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5
Q

What happens at a CPP < 50 mmHg?

A

Brain cannot be perfused adequately with oxygen and nutrients which results in loss of function

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6
Q

What happens at a CPP > 150 mmHg?

A

Loss of control of blood flow causing ischaemic forced vasodilation and brain oedema, which results in ICP and MAP becoming equal - no blood flow

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7
Q

Examples of causes of raised ICP

A

Inflammation e.g. menignitis, encephalitis, abscess
Vascular e.g. intracranial haemorrhage, brain swelling
Tumours
Hydrocephalus

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8
Q

Effects of intracranial space occupying lesions

A

Amount of tissue increases
Raised ICP puts CBF at risk
Can cause herniation between the intracranial spaces if focal

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9
Q

What are the thick, fibrous sheets inside the cranium that keep the brain in place?

A

Falx cerebri
Tentorium cerebelli
Dura mater

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10
Q

What are the openings around the fibrous sheets inside the cranium?

A

Subfalcine space
Tentorial hiatus
Foramen magnum

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11
Q

A focal lesion/mass can cause

A

internal shift between the intracranial spaces

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12
Q

In what direction might the cerebrum herniate?

A

Inferiorly via the tentorium

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13
Q

In what direction might the cerebellum herniate?

A

Inferiorly via foramen magnum

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14
Q

What percentage of brain tumours are primary tumours in adults?

A

65%

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15
Q

How are brain tumours classified?

A

By their resemblance to their cell of origin

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16
Q

Examples of glial cell tumours

A

Glioblastoma
Astrocytoma
Oligodendroglioma
Ependymoma

17
Q

Examples of primitive neuroectoderm tumours

A

Medullablastoma

18
Q

Examples of arachnoidal cell tumours

A

Meningioma

19
Q

Examples of nerve sheath cell tumours

A

Schwannoma

Neurofibroma

20
Q

Examples of pituitary gland tumours

A

Adenoma

21
Q

Examples of lymphoid cell tumours

A

Lymphoma

22
Q

Examples of capillary tumours

A

Haemangioblastoma

23
Q

Where are secondary tumours in the brain commonly metastasised from?

A 
Breast
Lung 
Kidney 
Colon 
Melanoma
24
Q

Features of ischaemic penumbra

A

Local ischaemia of brain tissue surrounding a tumour

Local loss of function

25
Q

Features of glioma

A

CNS supporting cells
Diffuse edges
Don’t metastasise outside of the CNS

26
Q

What is the highest grade of astrocytoma termed?

A

Glioblastoma, worst prognosis

27
Q

Why is the prognosis of glioblastoma poor?

A

Grows rapidly and responds poorly to surgery

28
Q

Features of medulloblastoma

A

Small, blue, round-cell tumour
Found mainly in children
Occur in posterior fossa, especially in brainstem
Poor prognosis

29
Q

Features of meningioma

A

From arachnocytes
Connective tissue tumours
Benign
Won’t metastasise but can be locally aggressive and invade the skull

30
Q

Features of nerve sheath tumours

A

Occur around the nerves
May be seen in CNS and PNS
Acoustic neuroma most common - causes unilateral deafness
Benign lesion but difficult to remove surgically
Can cause contralateral cranial nerve damage

31
Q

Features of pituitary adenoma

A

Benign tumour of posterior pituitary in pituitary fossa
Often secrete pituitary hormone
Many are non-functional
Cause panhypopituitarism
May result in acromegaly/gigantism due to growth hormone secretion
Grow superiorly and impinge on optic chiasma

32
Q

Features of CNS lymphoma

A 
High grade neoplasm 
Usually diffuse large B-cell lymphoma 
Often occur at deep and central sites 
Difficult to treat - drugs don't cross blood-brain barrier 
Generally don't spread outside CNS
33
Q

Features of capillary haemangioma

A

Space occupying
May bleed
Most common in cerebellar hemispheres

34
Q

Features of secondary brain tumours

A

Mostly carcinomas
Common metastases
Usually present with focal signs
Some can be removed surgically but dependent on site
Tend to be encapsulated and surrounded by oedema

Nervous System (44 decks)

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