Flashcards in Brain Tumours Deck (58)
1
What are the 2 general types of brain tumour?
Primary
Secondary metastatic
2
In primary tumors, what are the different type?
Glioblastoma
Meninges
Pituitary
3
What are the commonest tumours which spread to the brain?
Renal cell
Breast
Lung
Malignant melanoma
GI tract
4
What is the most common type of brain tumour?
Metastatic brain tumours
5
What cells are gliomas derived from?
Astrocytes
6
What stage is a GBM?
Stage IV
7
What are classed as primary malignant tumours?
Gliomas
8
In which meningeal layer do meningiomas usually present
Arachnoid
9
Where fo meningiomas usually present in the brain?
Along falx, convexity or sphenoid bone
10
Are meningiomas curable?
Yes by surgical excision
11
What is the common signs of pituitary adenoma?
Optic field defect - bitemporal hemianopia
hormone imbalance
12
What are the clinical presentations of a brain tumour?
Raised intracranial pressure
Focal neurological signs
Epileptic fit
CSF obstruction
13
What are the main symptoms of raised ICP?
Headache
Nausea/ vomiting
Diploia or blurred vision
Drowsiness
Cognitive impairment
Alter consciousness
14
What are the signs of raised ICP?
Papilloedema
3rd nerve palsy
6th nerve palsy
Altered consciousness
15
What is a RED FLAG sign of raised intracranial pressure?
Headache - worse in morning
16
What investigations would you do if suspected brain tumour?
CT scan (brain)
MRI
PET
CXR
Biopsy - skin or lymph
Mammography
17
What are some focal neurological deficits which may be observed?
Dysphagia
Hemiparesis
Hemianopia
Cognitive impairment
Cranial nerve palsy
Endocrine disorders
18
Patient presents with ataxia & incoordination, where is the lesion?
Cerebellum
19
Right handed patient presents with acalculia, agraphia, finger agnosia, left/ right confusion, where is the lesion?
Left parietal lobe
20
If patient presents with bitemporal hemianopia, where is the lesion?
Pituitary
21
If right handed patient presents with difficulty reading, difficulty expressed self, short term memory loss, where is the lesion?
Left temper-parietal area
22
What are the main management goals?
Reduce size of tumour (debunk)
Improve focal neurological signs
23
What type of management is available?
Steroids
Anticonvulsants
SuRgery
Radiotherapy
24
Are GBM operable?
Yes but not curative only debulk or biopsy
25
What treatment would be administered in someone with metastatic brain tumours?
Surgery
Radiotherpay
26
What is the prognosis for GBM?
1 YRS
27
What is the prognosis for meningioma?
Commonly cured with surgery
28
What is the prognosis for metastatic disease?
Medium term remission
29
Why do you NOT perform lumbar puncture in someone with brain tumour?
Risk of herniation syndrome and patient death
30
What tumours are classed as primary benign?
Pituitary adenoma
Meningioma
31
What are the presenting signs of brain tumour?
Raised ICP - nausea, headache, drowsiness
Focal neurological signs
Cognitive impairment
32
What are the names of the dural sheets which divide the brain?
Falx cerebri
Tentorium cerebelli
33
What are the localised lesion causes of increased intracranial pressure?
Haemtoma (haemorrhage)
Tumour
Abscess
34
What are some of the generalised causes of increased ICP?
Oedema post trauma
35
What are localised lesions also referred to as?
Space Occupying Lesions (SOL)
36
What types of herniation can occur what increased ICP?
Uncal herniation
Subfalcine (midline shift)
Coning - cerebellotonsillar herniation
37
Why is it called a subfalcine shift?
Falcine means falx therefore below falx cerebri
38
In an uncle herniation what happens?
Brain herniates inferiorly below tentorium
39
Cerebellar tonsil herniation causes what?
Brain stem death
40
What are some of the initial signs & symptoms of Increased ICP?
Morning headache & nausea
Papilloedema
41
What are some of the progressive signs of increased ICP?
Pupillary dilation
Falling GCS score
Brainstem death
42
What are the different types of gliomas?
Glioblastoma
Astrocytoma
Oligodendroctoma
Ependymoma
43
What is the cell type found in medulloblastomas?
Embryonic neural cells
44
What are meningiomas formed from?
Arachnoid cell
45
What tumours occur from nerve sheath cell?
Neurofibroma
Schwannoma
46
What tumour arises from blood vessels?
Haemangioblastoma
47
Which tumour type is a malignant childhood tumour?
Medulloblastoma
48
Where do the majority of brain tumours occur in adults/children?
Above tentorium
Below tentorium
49
Which cells do gliomas descend from?
Glial cells
50
Are gliomas malignant or benign?
Malignant
51
Which cells are glioblastomas formed from?
Astrocytes
52
What shape do astrocytes look like?
Star shaped
53
Where are medulloblastomas usually found?
In posterior fossa, in children
54
Are meningiomas benign or malignant?
Malignant
55
Where are schwannomas found?
Peripheral nerve sheaths
56
What is an acoustic neuroma?
Schwannoma of the 8th cranial nerve
57
What is the main sign of an acoustic neuroma?
Unilateral hearing loss
58