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The Nervous System: Pathology > Pathology of Brain Tumours > Flashcards

Pathology of Brain Tumours Flashcards

1
Q

What is the main effect of brain tumours

A

Raised intracranial pressure

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2
Q

What is three anatomically feature to consider in intracranial pressure

A

The cranium is a hard rigid closed box

Falx cerebri/tentorium cerebella -Thick rough fibrous sheet inside

Foramen magnum

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3
Q

How does pressure remain stable in the brain

A

The correct amount brain tissue, blood and CF within the cranium

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4
Q

What is the causes of raised intracranial pressure

A

Space occupying lesion (localised)

Generalised pathology

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5
Q

What is three examples of a space occupying lesion that causes raised intracranial pressure

A

Heamtoma
Tumour
Abscess

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6
Q

What is an examples of a generalised pathology that causes raised intracranial pressure

A

Post trauma oedema

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7
Q

How does space occupying lesion increase intracranial pressure

A

The amount of tissue increases there direct correlation increases the intracranial pressure

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8
Q

What is the pathological affect of raised intracranial pressure on the brain

A

Causes internal shift (herniation) between the intracranial spaces

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9
Q

What are the three directions of herniations that occur

A

Right- left or left - right

Cerebellum moves inferiorly over edge of tentorium

Cerebellum moves inferiorly into foramen magnum

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10
Q

What is the six different brain herniations

A

Cingulate (subfalcine)

Central

Uncal (transtentorial)

Cerebellotonsillar

Upward

Transcalvarial

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11
Q

What occurs in cingulate brain herniations

A

Falx pushed over to side (mid line shift) so the brain pushed away from the tumour

As the cingulate gyrus is pushed over to the side and herniates underneath falxi

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12
Q

What occurs as a result of cingulate hernatio

A

Lateral ventricles crushed flat and displaced downwards

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13
Q

What cause central herniation and what is the potentially result

A

occurs when there is downward pressure centrally and can result in bilateral uncal herniation

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14
Q

What is another name for uncal herniation

A

transtentorial herniation

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15
Q

What occurs in uncal hernation

A

Brain herniated at the side of the tentorieum

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16
Q

What is the affect of uncal herniation

A

Aqueduct is crushed and narrow

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17
Q

What occurs in cerebellotonsillar hernation

A

Cerebellum moved inwards and down into foramen magnum

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18
Q

What is the affect of cerebellotonsilar herniation

A

as cerebellum tonsils move inwards and downwards and crush brainstem resulting in brain stem death

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19
Q

What occurs in trancalvarial

A

Brain herniates out of cranium through skull fracture

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20
Q

What occurs as a result of swelling and shift in the brain

A

Localied ischaemia due to the tumour squeezing the nearby tissue

creating an ischaemia zone around the tumour

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21
Q

What symptoms occurs due to the affect of squeezing on cortex and brain stem

A

Morning headaches

Sickness

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22
Q

As pressure increases on the cortex and the brain stem what sign can be seen

A

A fallling score in the Glasgow coma scale

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23
Q

What is the sign seen due to raised intracranial pressure squeezing optic nerve (CN II) and squeezing and stretching occulomotor nerve (CNIII)

A

CN II - papilloedema

CN III- pupillary dilation

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24
Q

What is the overall symptoms and signs seen for increased pressure eon the brain

A

Morning headaches

Sickness

Papilloedema

Pupillary dialtion

Decreased Glasgow coma coma scale score

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25
What are common metastatic tumours in the CNS
``` Breast, Lung, Kidney, Colon, (GI tract) Melanoma ```
26
What are two examples of brain cell tumours
Gliomas - Gilal cells Medullablastoma - Embryonic neural cells
27
What kind of tumours are gliomas
Malignant tumours - but do not metastases outside the CNS
28
What is the morphology of gliomas
Resemble cells of glial differentiation - Astrocyte/ - oligodendrocyte - ependymal cells Diffuse edges not encapsulated
29
What is the main types of gliomas
Astocytoma - astrocyte (glioblastoma) Oligodendroglioma - ogliodendrocyte ependymomoa - ependymal cells
30
What can be seen in a low grade astrocytoma
Bland cells on microscopy similar to star shaped astrocyte cell Grow very slowly
31
What can be seen in astrocytoma and glioblastoma under the microscope
cellular, atypical tumour with necrosis If appear higher grade = glioblastoma
32
How are astrocytoma and glioblastoma the most malignant glioma
as grow very quickly and are often present as large tumours
33
What kind of tumour is medullablastoma and what is it derived from
Childhood malignant tumour tumour derived from primitive neuroctoderm (primitive neural cell)
34
Where is medullablastoma located
posterior fossa especially the brain stem
35
Where does medullablastoma metastases
other part of the brain and spinal cord
36
What is see under the microscope in medullblastoma
sheets of small undifferentiated cells
37
What tumours, originate from cells surrounding or originating outside the brain
Meningioma schwannoma neurofibroma adenoma lymphoma haemangioblastoma
38
Mengioma is a tumour of what cell
arachnoid cell - cells that make up the covering of the brain (arachnocytes)
39
What kind of tumour is meningioma
Benign (slow growing)
40
meningioma does not metastases but how does it spread
spreadse locally aggressive and invades the skull
41
What can be seen in the microscopy of meningioma
Bland cells foreign small groups resuming arachnoid granulation sometimes with calcification
42
How are meningioma treated
Surgery as often resectable
43
Schwannoma is a tumour of what cell
Schwann (nerve sheath) cells - which wrap around peripheral nerves and form electrical insulation (myelin sheath)
44
What is an example of a schwannoma
Acoustic neuroma - 8th vestibulocohlear nerve schwannoma
45
Where is an acoustic neuroma located,
At angle between pons and cerebellum
46
What is the symptoms of acoustic neuroma
unilateral deafness
47
What does the location of acoustic neuroma usually mean
removal is technically difficult
48
What is adenoma a tumour of
Pituitary gland in pituitary fossa | causes hormone imbalance
49
What type of tumour is an adenoma
benign
50
How does an adenoma grow and what affect does this have
Grows superiorly and impinges on optic chiasma causing visual problems
51
What is a lymphoma a tumour of
Lymphoid tissue
52
What kind of tumour is lymphoma
High grade neoplasm | of
53
What specific cell type of lymphoma affects the CNS
Usually diffuse large B- cell lymphoma
54
Where is lymphoma located in the CNS
Often deep and central site in the brain
55
What does the usually location of lymphoma usually mean
Difficulty to make biopsy difficulty yo treat as drugs cannot cross blood brain barrier
56
How far does lymphoma metastases
Doesn't spread outside of CNS
57
What is haemangioblastoma a tumour of
Blood vessels
58
What is the characteristic os a haemangioblastoma
Is space occupying lesion May bleed most often found in the cerebellum
59
Where are intracranial tumours more likely to be located in adults
majority tumours located above the tentorium
60
Where are intracranial tumours more likely to be located in
majority tumours located below the tentorium
61
What is the most common brain tumour seen clinically
Metastases
62
What is the most aggressive glioma
Glioblastoma multiforme (GBM)
63
How and where do glioma spread
by tracking through white mater and CSF pathway, don't metastases outside the CNS

The Nervous System: Pathology (25 decks)

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