Pathology Of Intracranial Tumours Flashcards
What are the thick fibrous sheets inside the brain called (what are their roles)
Falx cerebri
Terntorium cerebelli
Role is to keep the brain in place
What are some causes of raised ICP
Localised lesions
Generalised pathology
What are examples of localised lesions (3)
Haemorrhage (if localised Called a haematoma)
Tumour
Abscess
What is an example of generalised pathology causing a raised ICP
Oedema post trauma
What is the effect of intracranial space occupying lesions
Amount of tissue increases
Raises ICP
Causes internal shift (herniation) between intracranial spaces
What 4 things might happen when there is an internal shift (herniation) between the intracranial spaces
Cerebrum moves inferior over edge tentorium (tentorial herniation)
Shift from right-left or left-right under the falx
Cerebellum moves inferiorly into foramen magnum (coning)
Herniation of brain stem through foramen magnum (tonsilar herniation)
How does a tumour cause localised ischaemia
Tumours squeeze nearby tissue and cause local ischaemia around the tumour
What are the symptoms of pressure squeezing on the cortex and brainstem
Morning headaches and sickness
What are the symptoms of pressure squeezing on the optic nerve
Papilloedema (seen on fundoscopy)
What 3 things happen as pressure increases on the brain (pupillary dilation, GCS, brainstem)
Pupillary dilation - stretch and squeeze on cranial nerve 3
Falling GCS - squeeze on cortex and brainstem
Brain stem death - squeezing downwards of cerebellum into foramen magnum with crushing of brainstem (patient is dead)
What is the difference between central nervous system tumours and other intracranial tumours
Central nervous system = in the brain tissue (can be primary tumours or secondary metastatic tumours)
Other intracranial tumours = cells originations OUTSIDE brain and spinal cord
What are some of the more common tumours (gliomas) of the brain cells (glial cells) called
Astrocytoma (star shaped - grow very slowly)
Glioblastoma (star shaped - grow rapidly)
Oligodendroglioma
Ependymoma
MALIGNANT TUMOURS
What are tumours of the brain cells (embryonic neural cells) called
Medulloblastoma
CHILDHOOD MALIGNANT TUMOURS
What is a meningioma
Tumour of arachnoidal cell
What is a schwannoma/neurofibroma
Nerve sheath cell tumour
Where do most CNS tumours affect adults
Majority ABOVE tentorium (cerebral hemispheres)
Where do most CNS tumours affect children
Majority below tentorium (brainstem and cerebellum)
What is the pathological appearance of glioblastomas
Cellular, atypical, with necrosis under microscope
Grow rapidly - often present as large tumours
What are the characteristics of mengiomas
Benign - do NOT metastasise but can be locally aggressive and can invade the skull
Slow growing - often resectable
Pushes into the brain but doesnt usually invade it
