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Flashcards in Brain tumours Deck (62)
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1

What is a brain tumour?

Growth of cells
Benign or malignant
Primary or secondary
Supra or infratentorial
Extrinsic or intrinsic

2

What are common presentations for brain tumours?

Progressive neurological deficit
Motor weakness
Headache - raised ICP
Seizures

3

What can result in an increased ICP?

Contribution of mass within a rigid closed box
Tumour/ mass/ oedema mass effect
Hydrocephalus
Haemorrhage

4

What are symptoms of increased ICP?

Headaches
Vomiting
Mental changes
Seizures

5

What are different types of herniation?

Coning; tonsillar herniation
Uncal herniation
Subfalcine

6

What is cushing's reflex?

Hypertension
Bradycardia
Respiratory depression

7

What occurs with an uncal herniation?

Ipsilateral blown pupil as the herniation presses on the 3rd CN (can also get down and out pupil)

8

What is a bad sign with headaches?

If it wakes you up in the morning or worse in the morning

9

What should be done immediately with a headache worse in the morning?

FUNDOSCOPY to look for papilloedema

10

Why will increased ICP result in vomiting?

Increased pressure on the medulla

11

Will a headache associated with increased ICP get better or worse on coughing and leaning forward?

Worse

12

What should be given immediately if cushing's triad is present?

Mannitol

13

Where should you look if there are metastases in the brain?

Testes
Breasts
Melanoma (moles, subungal)
Axillary freckling for NF1

14

What are tumours of the neuroepithelial tissue?

Astrocytes
Oligodendroglial cells
Ependymal cells/ choroid plexus
Neuronal
Pineal
Embryonic - AFP, LDH, b-hcg

15

What is a grade 1 astrocytic tumour?

Pilocytic
Pleomorphic xanthoastroytoma
Subependymal glial cell

16

What is a grade 2 astrocytoma?

Low grade

17

What is a grade 3 astrocytoma?

Anaplastic astrocytoma

18

What is a grade 4 astrocytoma?

Glioblastoma multiforme

19

Describe a grade 1 astrocytoma

Benign
Slow growing
Children and young adults
Cerebellum affected

20

How are grade 1 astrocytomas treated?

Surgery

21

What are poor prognostic factors associated with low grade astrocytomas?

Age over 50
Focal deficit
Short duration of symptoms
Raised ICP
Altered consciousness
Enhancement on contrast studies

22

What is the treatment of a grade 2 astrocytoma?

Surgery +/- radio and chemo

23

What will low grade astrocytomas commonly present with?

Seizures

24

What is the median survival for an anaplastic astrocytoma?

2 years

25

What is the median survival for a glioblastoma multiforme?

14 months

26

Where will a GBM spread?

White matter tracking through corpus callosum and corticospinal tracts

27

What should you think about if there are multiple gliomas?

NF
Tuberous sclerosis
PML (Progressive multifocal leukoencephalopathy)

28

What is the treatment for GBM?

Non curative surgery to reduce mass effect
Post-op radiotherapy
If MGMT promoter myelination; should get treatment with oral alkylating chemotherapy

29

What will a GBM look like on MRI?

Heterogeneously enhancing SOL with areas of necrosis and a butterfly appearance

30

What is the grading of gliomas based off?

Cellular and nuclear atypia
Mitotic activity
Vascular endothelial proliferation
Necrosis