Space Occupying Lesions

Question 1

50% of primary intracranial tumors are what type?

Answer 1

gliomas

Question 2

What is the most common solid tumors in children?

Answer 2

Brain tumors

Question 3

What is the most common location for brain tumors in children?

Answer 3

the posterior fossa

Question 4

Balint syndrome

Answer 4

failure to turn eyes to a particular point in space

Question 5

Anton syndrome

Answer 5

denial of blindness and field defect

Question 6

What is the most common primary intraocular malignancy of childhood?

Answer 6

Retinoblastoma

Question 7

What reflex is absent in retinoblastoma?

Answer 7

No red reflex

Question 8

Describe the primary intracranial tumor described below:

Cancer that begins in the retina
No red reflex
Leukocoria “white pupil”

Answer 8

Retinoblastoma

Question 9

Describe the primary intracranial tumor described below:

Embryonal tumor of neural crest origin
Most common in the first years of life
Tumor usually in adrenal gland - Also frequent in thoracic and cervical sympathetic ganglia
70% secrete catecholamines

Answer 9

Neuroblastoma

Question 10

Describe the primary intracranial tumor described below:

Midline cerebellar lesion causes gait/balance deficits
Highly malignant
Tends to metastasize throughout CNS
Likely to cause obstruction of 4th ventricle and cause non-communicating hydrocephalus and increased ICP due to location and rapid growth

Answer 10

Medulloblastoma

Question 11

Describe the primary intracranial tumor described below:

Usually in the cortex and cerebellum
Causes fine motor deficits
Usually slow growing
Most common brain tumor in children

Answer 11

Astrocytoma

Question 12

What is the most common brain tumor in children?

Answer 12

Astrocytoma

Question 13

Metastatic Intracranial Tumors - most common primary tumor site is where?

Answer 13

the lungs

Question 14

What is a common intracranial complication with AIDs patients?

Answer 14

Primary cerebral lymphoma

Question 15

How is primary cerebral lymphoma treated?

Answer 15

whole-brain irradiation

Question 16

Why is imaging not helpful in primary cerebral lymphoma (making diagnosis difficult)?

Answer 16

MRI/CT cannot distinguish between lymphoma and toxplasmosis

Question 17

What are the three most common organism types in brain abscesses?

Answer 17

Streptococci
Staphylococci
anaerobes

Question 18

What are some causes of brain abscesses?

Answer 18

Sequalae of ear or nose disease
Hematogenous spread of infection
Trauma/surgery – sinus surgery for example

Question 19

What are some signs/symptoms of a brain abscess?

Answer 19

Fever
Malaise
Headache
Drowsiness
Inattention
Confusion
Seizures
Focal neurologic deficits
Increased ICP

Question 20

If a patient has a brain abscess, should you obtain a lumbar puncture?

Answer 20

No - Lumbar puncture is contraindicated!!

Question 21

Spinal Tumors:

What percentage is intra v extramedullary?

Answer 21

Intramedullary – 10%

Extramedullary – 90%

Question 22

What is the most common intramedullary spinal tumor?

Answer 22

Ependymoma

Question 23

What are the causes of dysfunction of spinal tumors?

Answer 23

Direct compression – can cause damage even if tumor is benign
Direct infiltration
Arterial/venous occlusion

Question 24

Neurofibromatosis Types

Answer 24

Type 1 - Recklinghausen Disease; Multiple hyperpigmented macules and neurofibromatosis

Type 2 - 8th nerve tumors accompanied by other intracranial/intraspinal tumors

Question 25

Neurofibromatosis Type I is also known as?

Answer 25

Recklinghausen Disease

Question 26

What are the associated cutaneous lesions seen in neurofibromatosis Type 2?

Answer 26

Associated cutaneous lesion include axillary freckling and patches of cutaneous
pigmentation - called Café au lait spots