Space-Occupying Lesions - Intracranial Tumours Flashcards

1
Q

What are Intracranial Tumours?

A

Abnormal growths within the brain, varying from benign Meningiomas to highly malignant Glioblastomas.

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2
Q

Common Cancers that Metastasise to the Brain (4).

A
  1. Lung.
  2. Breast.
  3. Renal Cell Carcinoma.
  4. Melanoma.
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3
Q

Types of Intracranial Tumours (4).

A
  1. Gliomas.
  2. Meningiomas.
  3. Pituitary Tumours.
  4. Acoustic Neuromas.
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4
Q

What are Gliomas?

A

Tumours of Glial cells in. CNS :

  1. Astrocytoma - Glioblastoma Multiforme (commonest subtype) - Most Malignant.
  2. Oligodendroglioma.
  3. Ependymoma - Least Malignant.
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5
Q

How are Gliomas Managed?

A

Grade from 1-4 (1 : Benign - Curable with Surgery; 4 : Malignant).

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6
Q

What are Meningiomas?

A

Benign Tumours growing from cells of the Meninges that can grow and cause a mass effect.

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7
Q

Pathophysiology of Meningiomas.

A

Arise from Arachnoid Cap Cells of Meninges, typically located next to the dura.

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8
Q

Clinical Features of Pituitary Tumours (2D).

A
  1. Bitemporal Hemianopia.
  2. Hormone Deficiencies - Hypopituitarism or Excess Hormones :
    A. Acromegaly.
    B. Hyperprolactinaemia.
    C. Cushing’s Disease.
    D. Thyrotoxicosis.
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9
Q

Management of Pituitary Tumours (4).

A
  1. Trans-Sphenoidal Surgery.
  2. Radiotherapy.
  3. Bromocriptine : Block Prolactin-Secreting Tumours.
  4. Somatostatin Analogues e.g. Ocreotide : Block GH-Secreting Tumours.
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10
Q

Epidemiology of Intracranial Tumours (3).

A
  1. Majority of Adult = Supratentorial.
  2. Majority of Child = Infratentorial.
  3. Commonest : Glioblastoma, Meningioma.
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11
Q

Paediatric Intracranial Tumours.

A
  1. Pilocytic Astrocytoma - Commonest.
  2. Medulloblastoma - Aggressive.
  3. Craniopharyngoma - Supratentorial.
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12
Q

Clinical Presentation of Intracranial Tumours.

A
  1. Small = Asymptomatic.
  2. Depending on Location = Focal Neurological Symptoms.
  3. Raised ICP Symptoms and Signs with Growth.
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13
Q

Clinical Features of Raised Intracranial Pressure (6).

A
  1. Headache.
  2. Altered Mental State.
  3. Visual Field Defects.
  4. Seizures - Focal.
  5. Unilateral Ptosis.
  6. 3rd + 6th Nerve Palsy.
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14
Q

Features of Headache in Raised Intracranial Pressure (4).

A
  1. Constant.
  2. Nocturnal.
  3. Worse on Waking, Coughing, Straining, Bending Forward.
  4. Vomiting.
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15
Q

Differential Diagnoses of Raised Intracranial Pressure (4).

A
  1. Brain Tumours.
  2. Intracranial Haemorrhage.
  3. Idiopathic Intracranial Hypertension.
  4. Abscesses/Infection.
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16
Q

Investigations of Intracranial Tumours.

A
  1. Fundoscopy - Raised ICP.
17
Q

Fundoscopy Changes of Raised Intracranial Pressure.

A
  1. Blurring of Optic Disc Margin.
  2. Elevated Optic Disc (retinal vessels curve over raised disc).
  3. Loss of Venous Pulsation.
  4. Engorged Retinal Veins.
  5. Haemorrhages Around Optic Disc.
  6. Paton’s Lines (Creases in Retina Around Optic Disc).
18
Q

Management of Brain Tumours (4).

A
  1. Surgery.
  2. Palliative Care.
  3. Chemotherapy.
  4. Radiotherapy.