Space-Occupying Lesions - Intracranial Tumours Flashcards
What are Intracranial Tumours?
Abnormal growths within the brain, varying from benign Meningiomas to highly malignant Glioblastomas.
Common Cancers that Metastasise to the Brain (4).
- Lung.
- Breast.
- Renal Cell Carcinoma.
- Melanoma.
Types of Intracranial Tumours (4).
- Gliomas.
- Meningiomas.
- Pituitary Tumours.
- Acoustic Neuromas.
What are Gliomas?
Tumours of Glial cells in. CNS :
- Astrocytoma - Glioblastoma Multiforme (commonest subtype) - Most Malignant.
- Oligodendroglioma.
- Ependymoma - Least Malignant.
How are Gliomas Managed?
Grade from 1-4 (1 : Benign - Curable with Surgery; 4 : Malignant).
What are Meningiomas?
Benign Tumours growing from cells of the Meninges that can grow and cause a mass effect.
Pathophysiology of Meningiomas.
Arise from Arachnoid Cap Cells of Meninges, typically located next to the dura.
Clinical Features of Pituitary Tumours (2D).
- Bitemporal Hemianopia.
- Hormone Deficiencies - Hypopituitarism or Excess Hormones :
A. Acromegaly.
B. Hyperprolactinaemia.
C. Cushing’s Disease.
D. Thyrotoxicosis.
Management of Pituitary Tumours (4).
- Trans-Sphenoidal Surgery.
- Radiotherapy.
- Bromocriptine : Block Prolactin-Secreting Tumours.
- Somatostatin Analogues e.g. Ocreotide : Block GH-Secreting Tumours.
Epidemiology of Intracranial Tumours (3).
- Majority of Adult = Supratentorial.
- Majority of Child = Infratentorial.
- Commonest : Glioblastoma, Meningioma.
Paediatric Intracranial Tumours.
- Pilocytic Astrocytoma - Commonest.
- Medulloblastoma - Aggressive.
- Craniopharyngoma - Supratentorial.
Clinical Presentation of Intracranial Tumours.
- Small = Asymptomatic.
- Depending on Location = Focal Neurological Symptoms.
- Raised ICP Symptoms and Signs with Growth.
Clinical Features of Raised Intracranial Pressure (6).
- Headache.
- Altered Mental State.
- Visual Field Defects.
- Seizures - Focal.
- Unilateral Ptosis.
- 3rd + 6th Nerve Palsy.
Features of Headache in Raised Intracranial Pressure (4).
- Constant.
- Nocturnal.
- Worse on Waking, Coughing, Straining, Bending Forward.
- Vomiting.
Differential Diagnoses of Raised Intracranial Pressure (4).
- Brain Tumours.
- Intracranial Haemorrhage.
- Idiopathic Intracranial Hypertension.
- Abscesses/Infection.