Brain Tumours

Question 1

What is the most common type of brain tumour?

Answer 1

Neuroepithelial tumours

52%

Question 2

What tumours are part of the neuroepithelial tumour family

Answer 2

Astrocytoma (44% of all tumours)

Ependymoma

Oligodendroglioma

Medulloblastoma

Question 3

What are some aetiologies for brain tumours?

Answer 3

Few environmental risk factors, such as exposure to radiation

FHx rare

Some conditions are predisposing, such as neurofibromatosis 1 and 2, and Li Fraumeni syndrome (p53 loss predisposing to glioma)

Question 4

What is the prognosis for glioblastoma multiforme?

Answer 4

Median survival 7-14 months

Question 5

What are some features of raised ICP in brain tumour patients?

Answer 5

Worse on waking, improves through day

Vomiting and nausea, vomiting may make headache better

Drowsiness is a very important, very late sign

Question 6

What is the Monro-Kellie doctrine with regards to raised ICP?

Answer 6

Says that there is some ability to compensate for increases in ICP, but at the point where the compensation is furthermore unavailable, ICP will precipitously increase

Question 7

What post tumour resection RRx should be given in malignant astrocytoma patients?

Answer 7

45-60 Gy in 20-30 fractions

To tumour bed + 2cm margins

Question 8

What post tumour resection chemotherapy should be given in malignant astrocytoma patients?

Answer 8

Temozolomide