Tumors Flashcards
T/F: neuro rehab is beneficial for patients with brain tumors
true
Though most tumors exist outside of the CNS, when they do present they are most like to occur where?
in the cerebrum
T/F: the majority of brain tumors are metastatic
false: though 40% of brain tumors are metastatic, most of them are not
two most common primary sites of brain metastases
lungs and breast
Primary brain tumors are classified by cell type. What are the three subcategories of glial tumors?
- astrocytomas/glioblastomas
- oligodendrogliomas
- ependymomas
what are astrocytomas/glioblastomas?
a type of glial cell brain tumor arising from the cells that support the brain in nutrition and waste
what are oligodendromas?
a type of glioma affecting the cells that produce myelin
what is an ependymoma?
a type of glioma affecting the cells that line the ventricles and is more common in teens and young adults.
gliomas represent what portion of brain tumors and what portion of malignancies?
30%; 80%
what are 4 types of common, nonglial tumors?
- meningiomas (most common primary brain tumor type)
- meduloblastoma
- schwannoma
- pituitary adenoma
what is a meningioma
the most common type of primary brain tumor (and also a nonglial tumor) that is usually benign and arises from the arachnoid layer of the meninges
what is a meduloblastoma
malignant nonglial tumor of the 4th ventricle which can likely metastasize via the CSF to other areas of the brain
what is a schwannoma
a benign nonglial tumor that affects myelin producing schwann cells
what does each of the four grades of brain tumor represent
classified by degree of malignancy
- discrete, slow, and similar to normal cells
- slow but can invade neighbor tissue
- actively reproducing cells that invade neighbor tissue
- rapid growth, proliferation, and infiltration - forms own blood supply and may have central necrosis
what is the most common malignant CNS tumor type
astrocytomas… glioblastoma multiform (GBM) aka gr IV astrocytoma
what is the most common benign tumor
meningioma
what tumor type is most likely to present with acoustic neuroma?
vestibular schwannoma
what is normal pressure hydrocephalus (NPH)?
a sign of a brain tumor resulting from increased ventricle pressure as a result of tumor growth
what are the two major sxs of brain tumor, generally
increased ICP and NPH
what is often the first sign of tumor pathology
seizures
what is the classic triad of sxs for increased ICP
- headaches
- papilledema (from pressure on the optic nerve)
- N/V
what are the 3 W’s assoc with NPH
- wet - incontinence
- wild - behavior change
- wobbly - gait devs
what are sxs of acoustic neuroma (3)
- early balance and hearing loss
- dizziness and vertigo
- facial nerve issues post op
how do you distinguish a UMN from LMN facial nerve injury
a UMN lesion will demonstrate equal eyebrow raising
what is a scale we can use to measure facial weakness
House Brackman Scale
what are two medical management implications for those being treated for brain tumors
- corticosteroids may lead to low BMD, lig lax, and steroid myopathy (proximal weakness)
- anticonvulsants for seizures
what are sxs that anticonvulsant medications are too high? too low?
high - cognitive lethargy
low - seizures
what is the purpose of steroids in brain tumor management
swelling management - no direct effect
what are the adverse effects of chemo
N/V, fatigue, compromised immunity
what are the three most common deficits in brain tumor patients
impaired cognition (80%), weakness (78%), and visual-perceptual deficits (53%)
T/F: there is an underreferral issue from oncology to rehab for patients with brain tumor
true: rehab is not automatic at the moment for brain tumor patients
what is the primary goal for patients in rehab for brain tumors
patient goals/QoL
