S7+8 Intracranial tumour surgery and radiotherapy

Question 1

How do intracranial tumours present?

Answer 1

Raised ICP - headache, vomiting, blurred vision.
Seizures.
Neurological deficits.
Endocrine - over/under.
Incidental discovery.

Question 2

Why perform surgery on intracranial tumours?

Answer 2

Diagnostic
Relieve mass effect.
Alleviate symptoms.
Treat symptoms.

Question 3

What is 5-ALA used of in surgery?

Answer 3

Tumour cells in brain take up 5-ALA. Filter allows visualisation of where tumours are.

Question 4

What are gliadel wafers?

Answer 4

Carmustine.

Allow direct input of chemotherapy into brain - overcoming the blood brain barrier.

Question 5

Why is photon therapy indicated in children and not adults?

Answer 5

Both deliver same high dose therapy. Photon therapy limits area of low dosage - preserves IQ and growth in children.

Question 6

What are the side effects of cranial radiotherapy:
Acute (3)
Intermediate (2)
Late (3)

Answer 6

Acute: oedema, hair loss, scalp erythema.
Intermediate: somnolence syndrome and symptom exacerbation.
Late: cataracts, hypopituitarism, memory loss

Question 7

When is radiotherapy for high grade gliomas recommended and why?

Answer 7

If young and fit and will survive long enough for side effects to pass.

Question 8

Treatment is curative for which types of rare CNS tumours?

Answer 8

Germ cell tumours.

Medulloblastomas.