tumours

Question 1

is primary or secondary brain tumours more common

Answer 1

secondary (mets)

Question 2

symptoms of brain tumour

Answer 2

-headaches
-seizures
-N&V
-blurred vision
-weakness/paralysis
-speech problems
-mental/personality changes

Question 3

CANCER headache

Answer 3

-worse on lying down or in morning
-associated N&V
-headache pattern in erratic
-tension like
-vomiting is prolonged and repetitive
-new motor weakness
-worsens with valsalva

Question 4

where can the tumours come from

Answer 4

-mets
-meninges
-neuroepithelial tissue
-nerve sheath cells
-germ cells
-haemapoetic/lymphomas

Question 5

astrocytoma WHO grading

Answer 5

I - pilocytic astrocytoma
II - low grade astrocytoma
III - anaplastic astrocytoma
IV - glioblastoma multiforme

Question 6

pilocytic astrocytoma

Answer 6

-benign, slow growing
-most common in children
-often seen around cerebellum, brainstem

Question 7

treatment for a pilocytic astrocytoma

Answer 7

surgical resection

Question 8

low grade astrocytoma

Answer 8

benign
-vascular proliferation
-abnormal nucleus
-usually in temporal lobe or around central gyrus

Question 9

treatment for a low grade astrocytoma

Answer 9

surgery +/- radiation or chemo

Question 10

anaplastic astrocytoma

Answer 10

malignant
nucleus is rly rly weird
mitoses
can happen by itself or come from a lower grade one
survival 2 years

Question 11

glioblastoma multiforme

Answer 11

-necrosis and neovascularisation
-BUTTERFLY appearance
-survival is less than 1 year
-rarely mets outside the brain

Question 12

treatment

Answer 12

non-curative
-surgery
-radiotherapy
-cant drive after operation because of seizure risk

Question 13

what type of tumour is an oligodendroglioma

Answer 13

glial tumour

Question 14

where are oligodendrogliomas found

Answer 14

frontal lobes usually

Question 15

features of oligodendrogliomas

Answer 15

-calcification
-cysts
-peritumoural haemorrhage
-greyish pink
-subarachnoid accumulations give TOOTHPASTE APPEARANCE

Question 16

treatment for oligodendrogliomas

Answer 16

surgery
chemo
radiotherapy

Question 17

is a meningioma benign or malignant

Answer 17

BENIGN

Question 18

meningioma features

Answer 18

-extra-axial
-often asymptomatic
-headache, regional anatomical disturbance
-slow growing

Question 19

what is a meningioma en plaque

Answer 19

carpet/sheet like lesion infiltrating dura

Question 20

treatment for meningiomas

Answer 20

-surgery
-radiotherapy
-5 year survival 90%

Question 21

CT results for meningioma

Answer 21

-homogenous
-densely enhancing
-oedema

Question 22

MRI of a meningioma

Answer 22

-dural tail
-patent dural sinuses

Question 23

types of nerve sheath tumours

Answer 23

-shwannomas
-neurofibromas
-acoustic neuroma
-cerebellopontine angle tumour

Question 24

symptoms of nerve sheath tumours

Answer 24

-hearing loss
-tinnitus
-dysequilibrium
-can affect CN 5 and 7 (lose blink reflex)
-brainstem (hydrocephalus)

Question 25

who gets germ cell (pineal) tumours

Answer 25

under 20 yrs
males

Question 26

what does a pineal tumour look like on CT

Answer 26

hyperdense and enhancing

Question 27

two types of pineal tumour

Answer 27

germinomas and non-germinatous

Question 28

what should be checked for any midline brain tumour in child

Answer 28

-AFP
-beta-HCG
-LDH

Question 29

features of a hemangioblastoma

Answer 29

-bening
-cystic
-very vascular
-associated VHL

Question 30

name the low grade tumours

Answer 30

• Meningiomas
• Acoustic neuromas
• Pituiary tumours
• Pineal tumours
• Craniopharyngiomas
• Neurofibromas

Question 31

name the high grade tumours

Answer 31

• Gliomas and glioblastoma multiforme
• Primary cerebral lymphomas
• Medulloblastomas