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Neurology Year 3 > Tumours of the Nervous system > Flashcards

Tumours of the Nervous system Flashcards

1
Q

What are some features of tumours in the CNS?

A

Neurological deficit
Motor weakness
Headache
Seizures

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2
Q

What are the neurological signs associated with Frontal lobe tumours?

A

Personality changes, increased aggresion, irritation, apathy, unilateral weakness, loss of smell, difficulty walking, vision & speech problems

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3
Q

What are the neurological signs associated with Temporal lobe tumours?

A

memory loss, language deficits, forgetting words, seizures

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4
Q

What are the neurological signs associated with parietal lobe tumours?

A

intellect, thought reasoning, sensation, hearing, memory, Difficulty speaking / understanding Problems reading/writing Loss of feeling in part of the body

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5
Q

What are the neurological signs associated with occipital lobe tumours?

A

Issues with sight

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6
Q

Describe the type of headache that presents in tumours?

A

Worse in the morning; wakes them up with coughing / leaning forward.

May be associated with vomiting OR symptoms like tension HA / migraine!

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7
Q

How is tumours diagnosed in the CNS?

A

CT/MRI scan

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8
Q

What is the most common primary tumour in adults?

A

Glioblastoma multiforme

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9
Q

Describe the appearance of Glioblastoma multiforme on imaging?

A

Solid tumours with central necrosis and a rim that enhances with contrast

Disruption of the blood-brain barrier and therefore are associated with vasogenic oedema (cerebral oedema).

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10
Q

Describe the appearance of Glioblastoma multiforme on Histology?

A

Pleomorphic tumour cells border necrotic areas

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11
Q

What is the treatment for Glioblastoma Multiforme?

A

Surgical with postoperative chemotherapy and/or radiotherapy.

Dexamethasone is used to treat the oedema.

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12
Q

What type of tumour is Glioblastoma multiforme?

A

Astrocytoma

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13
Q

What is the prognosis of Glioblastoma multiforme?

A

Very fast growing - poor prognosis of 1 year.

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14
Q

What is the second most common primary brain tumour in adults?

A

Meningioma

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15
Q

Describe the histology of Meningioma?

A

Spindle cells in concentric whorls and calcified psammoma bodies

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16
Q

Where do meningiomas arise?

A

Dura mater of the meninges and cause symptoms by compression rather than invasion.

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17
Q

Are meningiomas benign or malignant?

A

benign, extrinsic tumours of the central nervous system

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18
Q

What is a vestibular schwannoma (acoustic neuroma)?

A

Benign tumour arising from the eighth cranial nerve (vestibulocochlear nerve).

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19
Q

Bilateral vestibular schwannomas are asssociated with what condition?

A

Neurofibromatosis type 2

20
Q

What are the signs of vestibular schwannomas?

A

Hearing loss, facial nerve palsy (due to compression of the nearby facial nerve) and tinnitus

21
Q

What is the histology of vestibular schwannomas seen?

A

Antoni A or B patterns are seen. Vero cay bodies (acellular areas surrounded by nuclear palisades)

22
Q

What is the most common primary brain tumour in children?

A

Pilocytic astrocytoma

23
Q

What is the histology seen in Pilocytic astrocytoma?

A

Rosenthal fibres (corkscrew eosinophilic bundle)

24
Q

What is a medulloblastoma?

A

Aggressive paediatric brain tumour that arises within the infratentorial compartment. It spreads through the CSF system.

25
Q

What is the histology seen in medulloblastoma?

A

Small, blue cells. Rosette pattern of cells with many mitotic figures

26
Q

What is an Ependymoma?

A

Commonly seen in the 4th ventricle – ependymal cells are columnar epithelial cells of the CNS that line the ventricles.

27
Q

What is the histology seen in Ependymoma?

A

perivascular pseudo rosettes bodies.

28
Q

What is a major sign of ependymoma?

A

hydrocephalus

29
Q

What is a oligodendroma?

A

Benign, slow-growing tumour common in the frontal lobes, oligodendrocytes produce myelin in the CNS.

30
Q

What is the histology seen in Oligodendroma

A

Calcifications with ‘fried-egg’ appearance

31
Q

Are oligodendromas benign or malignant?

A

Benign

32
Q

What is a Hemangioblastoma?

A

Vascular tumour of the cerebellum – cerebellar signs

33
Q

What condition is associated with the development of Hemangioblastoma?

A

Von Hippel-Lindau syndrome

34
Q

What is the histology seen with Hemangioblastoma?

A

Foam cells and high vascularity

35
Q

What is a pituitary adenoma?

A

benign tumours of the pituitary gland - secretory (producing a hormone in excess) or non-secretory.

36
Q

What is Von Hippel-Lindau syndrome?

A

rare genetic disorder with multisystem involvement. Visceral cysts and benign tumours with potential for malignant transformation.

37
Q

What is a microadenoma?

A

Smaller than 1cm

38
Q

What is a macroadenoma?

A

Larger than 1cm

39
Q

What are the signs of a pituitary adenoma?

A 
Hormone excess (e.g. Cushing’s due to ACTH, acromegaly due to GH) 
bitemporal hemianopia
40
Q

What visual defect is associated with a pituitary adenoma?

A

Bitemporal hemianopia

41
Q

What investigations are done for pituitary adenomas?

A

Pituitary blood profile and MRI.

42
Q

What treatments are done for pituitary adenomas?

A

Hormonal or surgical (e.g. transsphenoidal resection).

43
Q

What is the most common paediatric supratentorial tumour?

A

Craniopharyngioma

44
Q

What is a craniopharyngioma?

A

Solid/cystic tumour of the sella region that is derived from the remnants of Rathke’s pouch.

It is common in children but can present in adults also.

45
Q

What are the features of craniopharyngioma?

A

Hormonal disturbance, symptoms of hydrocephalus or bitemporal hemianopia.

46
Q

What investigations are done for craniopharyngiomas?

A

pituitary blood profile and MRI

47
Q

What treatments are done for craniopharyngiomas?

A

Surgical with or without postoperative radiotherapy.

Neurology Year 3 (22 decks)

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