Neurosurgery Module: Neuro-oncology

Question 1

what are symptoms of cerebellar dysfunction and how can they be remembered?

Answer 1

DANISH
dysdiadokinesis
ataxia - broad based gait
nystagmus
intention tremor
speech (scanning dysarthria)
hypotonia

Question 2

how can you test for an intention tremor in an exam?

Answer 2

finger to nose test

Question 3

how can you test for nystagmus in an exam?

Answer 3

H test

Question 4

a patient with a thalamic infarction will present with what?

Answer 4

hemiparesis
spontaneous pain
hemichorea
impaired consciousness

Question 5

where is the subthalamus found?

Answer 5

immediately caudal to the thalamus

Question 6

damage to the basal ganglia will primarily cause what problem?

Answer 6

alter muscle activity and tone (deficiency or excess of movement)

Question 7

“pill rolling” tremor

Answer 7

parkinsons (thumb flexed to touch index)

Question 8

main symptom of huntingtons

Answer 8

chorea

Question 9

4 main CNS tumour symptoms

Answer 9

focal neuro deficit
headaches
seizures
cognitive slowing/personality changes

Question 10

describe tumour headaches

Answer 10

worse on lying down
accompanied N+V
raised ICP symptoms

Question 11

lesions of the primary motor cortex cause __lateral weakness

Answer 11

contra

Question 12

personality changes, urinary incontinence, seizures and weakness in 1 side indicates a problem in what lobe?

Answer 12

frontal

Question 13

temporal lobe symptoms?

Answer 13

memory deficits
contralateral superior quadrantanopia
seizures
potentially aphasia/dysphasia

Question 14

if a patient had expressive aphasia and dysphagia where could the lesion be?

Answer 14

wernickes area in the temporal lobe

Question 15

what visual problem would be present if the temporal lobe was affected? where would it present?

Answer 15

superior quadrantanopia in the CONTRAlateral eye

Question 16

contralateral inferior quadrantanopia, right/left side brain dysfunction indicates a lesion where?

Answer 16

parietal lobe

Question 17

neglect (a deficit in awareness of 1 side of the body) is a symptom of a problem with the ___ side of the brain

Answer 17

right

Question 18

what visual problem would an occipital lobe problem present with?

Answer 18

homonymous hemianopia in the CONTRAlateral eye

Question 19

homonomous hemianopia and visual hallucinations indicates…

Answer 19

a problem with the occipital lobe

Question 20

most common primary brain tumours?

Answer 20

high grade glioma

Question 21

who gets glioblastoma multiforme?

Answer 21

60-70 yr olds

Question 22

glioblastoma is best seen on what imaging?

Answer 22

MRI

Question 23

“butterfly appearance of tumour on imaging”

Answer 23

glioblastoma

Question 24

most common form of low grade glioma

Answer 24

pilocytic astrocytoma

Question 25

most common area for a pilocytic astrocytoma?

Answer 25

cerebellum

midline structures eg thalamus/chiasm

Question 26

oligodendrogliomas affect….

Answer 26

the frontal lobe of the cerebral hemisphere

Question 27

meningiomas are intracranial T or F

Answer 27

T

Question 28

who gets meningiomas?

Answer 28

people in their 60s-70s, mainly women

Question 29

patients with what coniditon have a higher risk of developing multiple meningioma?

Answer 29

NF2

Question 30

main PC for meningioma?

Answer 30

mainly asymptomatic but can present with headache

Question 31

pituitary adenomas arise in what part of the pituitary gland?

Answer 31

anterior lobe

Question 32

most common cause of chiasmal compression in adults?

Answer 32

macroadenomas

Question 33

when would you suspect a patient with an acoustic neuroma has NF2?

Answer 33

if its bilateral

if the patient is young

Question 34

most common PC of acoustic neuroma?

Answer 34

unilateral sensorineural hearing loss
tinnitus
vertigo

Question 35

haemangioblastomas develop in the ___ fossa, which leads to what symptoms?

Answer 35

posterior 
cerebellar dysfunction (DANISH)

Question 36

haemangioblastomas are associated with what condition?

Answer 36

von-hippel lindau syndrome