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Neurology > Space occupying lesions > Flashcards

Space occupying lesions Flashcards

1
Q

What is the most common primary brain tumour in adults?

A

Glioblastoma

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2
Q

What are the presenting features of glioblastoma?

A
  • Signs of raised ICP (headaches etc)
  • Seizures
  • Focal neurological deficits
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3
Q

What is the typical appearance of glioblastoma on imaging?

A
  • Solid tumour (irregular in shape + size) with central necrosis surrounded by a rim that enhances with contrast
  • Vasogenic oedema (due to disruption of BBB)
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4
Q

What is the typical histopathological appearance of glioblastomas?

A

Pleomorphic tumour cells border necrotic areas

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5
Q

What is the management of glioblastomas?

A

Surgical removal with post-operative chemotherapy ± radiotherapy
Dexamethasone for oedema

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6
Q

What is the 2nd most common primary tumour is adults?

A

Meningioma

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7
Q

What are the presenting features of meningiomas?

A
  • Mostly asymptomatic
  • Seizures
  • Focal neurological signs (i.e. depends on location of the tumour)
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8
Q

Where in the cranium do meningiomas typically occur?

A
  • Falx cerebri
  • Superior sagittal sinus
  • Skull base
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9
Q

From which type of cells do meningiomas arise?

A

Arise from the arachnoid cap cells of the meninges

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10
Q

What is the histopathological appearance of meningiomas?

A

Spindle cells in concentric whorls and calcified psammoma bodies

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11
Q

What is the management of meningiomas?

A
  • Observation
  • Radiotherapy
  • Surgical resection
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12
Q

What are the presenting features of vestibular schwannomas?

A
  • Sensorineural hearing loss
  • Tinnitus
  • Dizziness/vertigo
  • Sometimes CN V and VII palsies
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13
Q

What is the most common location for vestibular schwannomas to develop?

A

Cerebellopontine angle

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14
Q

Which condition are vestibular schwannomas classically associated with?

A

Neurofibromatosis type 2

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15
Q

Describe the histopathological appearance of vestibular schwannomas?

A
  • Antoni A or B patterns

- Verocay bodies (acellular areas surrounded by nuclear palisades)

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16
Q

What is the management of vestibular schwannomas?

A
  • Observation
  • Radiotherapy
  • Surgical resection
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17
Q

What is the most common primary brain tumour of childhood?

A

Pilocytic astrocytoma

18
Q

What are the presenting features of pilocytic astrocytomas?

A

DANISH:

  • Dysdiadochokinesis
  • Ataxia
  • Nystagmus
  • Intention tremor
  • Slurred/staccato speech
  • Hypotonia
  • Features of raised ICP
19
Q

Describe the histopathological appearance of pilocytic astrocytomas.

A

Rosenthal fibres (corkscrew eosinophilic bundle)

20
Q

What is the management of pilocytic astrocytomas?

A

Surgical resection + chemotherapy

21
Q

What are the presenting features of ependymoma?

A

Raised ICP (headaches, papilloedema, N+V)

22
Q

Where in the cranium do ependymomas most commonly occur?

A

4th ventricle

23
Q

Describe the histopathological appearance of ependymomas.

A

Perivascular pseudorosettes

24
Q

What is the management for ependymomas?

A

Surgical resection + chemotherapy

25
Q

What are the presenting features of an oligodendroma?

A
  • Seizures
  • Focal neurological deficits
  • Personality changes (location in frontal lobe)
26
Q

Where in the cranium do oligodendromas typically occur?

A

Frontal lobe

27
Q

Describe the histopathological appearance of oligodendromas.

A

Calcifications with ‘fried-egg’ appearance

28
Q

What is the management of oligodendromas?

A
  • Watchful waiting

- Benign and slow-growing therefore intervention is rarely needed

29
Q

How do pituitary microadenomas present?

A

Asymptomatic

30
Q

How do pituitary macroadenomas present?

A
  • Hypopituitarism
  • Headache
  • Bitemporal hemianopia (upper quadrant > lower quadrant)
31
Q

What is the management of pituitary adenomas?

A

Trans-sphenoidal surgical resection

32
Q

Which brain tumour of childhood is the most malignant?

A

Medulloblastoma

33
Q

Which part of the cranium do medulloblastomas typically occur?

A

Infratentorial compartment

34
Q

What is the histopathological appearance of medulloblastomas?

A
  • Small blue cells

- Rosette pattern of cells with many mitotic figures

35
Q

What is the management of medulloblastomas?

A

Surgical resection + chemotherapy

36
Q

What is the most common paediatric supratentorial tumour?

A

Craniopharyngioma

37
Q

What are the presenting features of craniopharyngiomas?

A
  • Hormonal disturbance
  • Symptoms of hydrocephalus/raised ICP
  • Bitemporal hemianopia
    (lower quadrant > upper quadrant)
38
Q

Describe the cellular origin of craniopharyngiomas.

A

Solid/cystic tumours of the sellar region that are derives from the remnants of Rathke’s pouch

39
Q

What is the management of craniopharyngiomas?

A

Surgical resection ± post-operative radiotherapy

40
Q

What brain tumour is commonly associated with von Hippel-Lindau syndrome?

A

Haemangioblastoma

Neurology (46 decks)

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