Flashcards in Brain tumours Deck (62)
What is a brain tumour?
Growth of cells
Benign or malignant
Primary or secondary
Supra or infratentorial
Extrinsic or intrinsic
What are common presentations for brain tumours?
Progressive neurological deficit
Headache - raised ICP
What can result in an increased ICP?
Contribution of mass within a rigid closed box
Tumour/ mass/ oedema mass effect
What are symptoms of increased ICP?
What are different types of herniation?
Coning; tonsillar herniation
What is cushing's reflex?
What occurs with an uncal herniation?
Ipsilateral blown pupil as the herniation presses on the 3rd CN (can also get down and out pupil)
What is a bad sign with headaches?
If it wakes you up in the morning or worse in the morning
What should be done immediately with a headache worse in the morning?
FUNDOSCOPY to look for papilloedema
Why will increased ICP result in vomiting?
Increased pressure on the medulla
Will a headache associated with increased ICP get better or worse on coughing and leaning forward?
What should be given immediately if cushing's triad is present?
Where should you look if there are metastases in the brain?
Melanoma (moles, subungal)
Axillary freckling for NF1
What are tumours of the neuroepithelial tissue?
Ependymal cells/ choroid plexus
Embryonic - AFP, LDH, b-hcg
What is a grade 1 astrocytic tumour?
Subependymal glial cell
What is a grade 2 astrocytoma?
What is a grade 3 astrocytoma?
What is a grade 4 astrocytoma?
Describe a grade 1 astrocytoma
Children and young adults
How are grade 1 astrocytomas treated?
What are poor prognostic factors associated with low grade astrocytomas?
Age over 50
Short duration of symptoms
Enhancement on contrast studies
What is the treatment of a grade 2 astrocytoma?
Surgery +/- radio and chemo
What will low grade astrocytomas commonly present with?
What is the median survival for an anaplastic astrocytoma?
What is the median survival for a glioblastoma multiforme?
Where will a GBM spread?
White matter tracking through corpus callosum and corticospinal tracts
What should you think about if there are multiple gliomas?
PML (Progressive multifocal leukoencephalopathy)
What is the treatment for GBM?
Non curative surgery to reduce mass effect
If MGMT promoter myelination; should get treatment with oral alkylating chemotherapy
What will a GBM look like on MRI?
Heterogeneously enhancing SOL with areas of necrosis and a butterfly appearance