Primary And Seconday Brain Tumours

Question 1

Primary tumours (less common than 2’)

Answer 1

Astrocytoma graded (90%) 1 - 4 by WHO
1 - benign
4 - glioblastoma (v.bad prognosis, death within 1 year)
Oligodendrocytoma
Meningioma + Schwannoma

Question 2

Primary tumour Sx

Answer 2

Increase ICP
- Cushing triad = Increase partial pressure, bradycardia, irregular breathing
- papilloedema
- CN6 palsy
Focal neurology
Epileptic seizures
Lethargy + wt loss

Question 3

Primary tumour Dx

Answer 3

MRI head = locate tumour then…
Biopsy = grade
No lumbar puncture = MASSIVE CI

Question 4

Primary tumour Tx

Answer 4

Surgery (remove tumour if possible and decrease ICP)
+ chemo before/during/after surgery
Steroids = dexamethasone (may help)

Question 5

Secondary brain tumours (much more common)

Answer 5

NSCLC (MC) + SCLC
Breast
Melanoma
Renal cell carcinoma
Gastric cancer

Question 6

Secondary tumour Tx

Answer 6

Often metastasised = grade 3/4 (severe) = CHEMO + PALLIATIVE CARE