SOLs Flashcards
TRUE/FALSE
More than 2/3 of tumours present with focal localising symptoms
TRUE
Why are headaches worse in the morning?
Slightly hypercapnic overnight as we retain CO2 while we sleep
Result in increasing cerebral blood flow and a commensurate increase in the size of the brain
Brain tumours are what percentage of childhood tumours?
20%
Why is the tentorium cerebella important in brain tumours?
In children- 70% arise below tentorium cerebelli
In adults- 70% arise above the tentorium cerebelli
What is the most subtype of brain tumour in adult?
Astrocytoma
What is the most common brain tumour in children?
Pilocytic astrocytoma
What are the most common tumour within the cranial cavity?
Metastases
What is the classic presentation of brain tumour?
Progressive neurological deficit Motor Weakness Headache Seizures Tiptoeing/Ataxia Vomiting
If headache with tiptoeing, ataxia and vomiting in children what is the differential you are considering?
Posterior foss tumour
What are the 5 aetiologies of tumour headache?
1-Raised ICP
2-Invasion/Compression of dura or periosteum
3-Secondary to diplopia or difficulty focusing
4-Extreme hypertension (as part of Cushing’s triad)
5-Psychogenic
If someone comes in with a headache what investigation should always be done?
Fundoscopy
What are the stem cells of the nervous system?
Neuroepithelial cells
What do neuroepithelial cells derive from?
Pluripotent stem cells
What defines grade IV astrocytic tumours?
If necrosis then glioblastoma multiform (grade IV)
Post astrocytic tumour removal it is safe to drive TRUE/FALSE
BOI ARE YA PLAYING
Not safe if there is a seizure risk or if left with some degree of visual field deficit. Have to inform DVLA
If you leave grade 1 astrocytic tumours alone they will go away TRUE/FALSE
FALSE
surgery is curative
If you leave them alone they will go blind
How do low grade astrocytoma present?
Seizures
Where are grade 1 tumours found?
Cerebellum
Where are grade II tumours commonly found?
Temporal bone
How do grade IV astrocytic tumours spread?
Via white matter tracking/CSF pathways
All astrocytic tumour surgery and treatment is curative TRUE/FALSE
Sadly not
Grade 1-Curative
Grade 2-?
Grade 3/4- Non-curative
Which group of tumours are described as having “toothpaste morphology”
Oligodendroglia tumours
What is the median survival with oligodendrocyte tumours?
10 years
What are the 5 types of brain tumours?
Astrocytic tumours Oligodendroglia tumours Meningiomas Nerve Sheath Tumours Germ cell Tumours
Which types of tumour coexist with astrocytic cells in a neoplastic collision type tumour?
Astrocytic tumours
What are meningiomas?
Tumours that form on the membranes that cover the brain and spinal cord just inside the skull
Most meningiomas are asymptomatic. If there is symptoms what will they be?
Headaches
Cranial nerve neuropathies
Regional autonomic disturbances
What do meningiomas form due to?
Radiation exposure
What is the grading tool used for meningioma resection?
Simpson grading
this predicts symptomatic recurrence based on how well you resect the tumour
What are the 3 types of nerve sheath tumours?
Schwannoma
Neurofibroma
Malignant Peripheral Nerve Sheath Tumour
What is another name for vestibular schwannoma of the 8th nerve?
Acoustic neuroma
The midline brain tumour known as a germ cell tumour has a classic age range of…
10-12 y/o males
How do germ cell tumours mainly metastasise?
Via the CSF
AFP is raised in which brain tumours?
Yolk sac tumours
HCG is raised in which brain tumours?
Choricocarcinoma
Germinoma
Many others
Where do multiple abscesses tend to occur?
At grey and white matter boundry
Why does the effect of the SOL tend to be much greater than the SOL itself?
Generalised oedema round the SOL
What is used in the diagnosis of abscess in the brain?
CT (with contrast)
How is brain abscess treated
Drainage of pus if there is any
Antibiotics- Ceftriaxone and Metronidazole empirically (modify post colture 6wks)
