Intracranial Tumours

Question 0

Which cranial nerves are usually affected by true localizing deficits in intracranial tumours?

Answer 0

CN III & VI

Question 1

What is the most common presentation of intracranial tumours?

Answer 1

Focal neurological deficit

Either cranial nerve, lobar or brainstem

Question 2

Which cranial nerves are associated with the cavernous sinus, and are therefore affected by tumours in the cavernous sinus region?

Answer 2

CN III, IV, V1, V2 & VI

Question 3

What deficits are seen in tumours affecting the temporal lobe?

Answer 3

Receptive (Wernicke’s) aphasia
Memory problems
Auditory problems (Heschl’s gyrus = primary auditory centre)
Superior quadrantalopia

Question 4

What is Heschl’s gyrus in the temporal lobe?

Answer 4

Primary auditory centre

Question 5

What is Gerstmann’s syndrome?

Answer 5

Dysgraphia, dyslexia, dyscalculia, finger-nose agnosia

Seen in tumours affecting dominant parietal lobe

Question 6

What is seen in patients with tumours affecting the dominant parietal lobe?

Answer 6

Gerstmann’s syndrome

Dysgraphia, dyslexia, dyscalculia, finger-nose agnosia

Question 7

What is seen in patients with a tumour affecting the non-dominant parietal lobe?

Answer 7

Visuospatial problems
Apraxia
Inattention/neglect
Contralateral inferior quadrantalopia

Question 8

What problems are seen in patients with tumours affecting the frontal lobe?

Answer 8

Expressive dysphasia (only if affecting Broca’s in dominant lobe)

Executive function (attention, decision-making, emotions, personality)

Question 9

What is important about the cerebellum’s infratentorial location?

Answer 9

It means cerebellar signs are ipsilateral

Question 10

What cerebellar signs are seen in patients with tumours affecting that region?

Answer 10

Ataxic gait
Action tremor
Jerky irregular movements

Ipsilateral signs

Question 11

What cranial nerves are associated with the pontomedullary junction?

Answer 11

CN V, VI & VII

Question 12

What are the characteristics of an increased ICP headache?

Answer 12

Worse in the morning
Exacerbated by bending/stooping
Bilateral, often global
Not severe

Question 13

What is the treatment of a prolactinoma?

Answer 13

Bromocriptine

Dopamine agonist
Dopamine exerts negative feedback on prolactin & shrinks tumour)

Question 14

What is the most common intracranial tumour?

Answer 14

Metastatic tumour

Bronchus and breast most common

Question 15

What are the most common primary intracranial tumours in adults?

Answer 15

Meningioma (25%)
Pituitary adenoma (25%)

Question 16

What does irregular contrast enhancement of a lesion seen on a CT scan indicate?

Answer 16

Malignant astrocytoma

Question 17

What does homogenous enhancement of a lesion seen on a CT scan indicate?

Answer 17

Meningioma

Question 18

What is the difference between radiosurgery and radiotherapy in the management of intracranial tumours?

Answer 18

Radiotherapy = fractionated (multiple) treatments

Radiosurgery = one-off radiation treatment

Question 19

What visual defect is caused by pituitary tumours?

Answer 19

Bitemporal hemianopia

Compression of nasal fibers decussating at the optic chiasm

Question 20

Of what is depression of the corneal reflex an early sign?

Answer 20

Acoustic neuroma in CPA

due to 5th nerve compression