CNS Tumors / Space Occupying Lesions Flashcards
What two primary tumors are most commonly found in the brain?
Glioma (MC adults and children)
~~ Astrocytoma
~~ Glioblastoma
~~ Oligodendroma
~~ Ependymoma (MC spinal cord tumor)
MeningiomaIf there is a lesion/tumor in the brain is it most likely a metastatic site or primary tumor?
Metastatic lesions are MC
What is the classic presentation of a PT with a brain tumor?
Seizures (focal or gen.) Focal neuro deficits Cognitive Dysfunction S/Sx of ICP (HA, nausea, papilledema) HA (<1% of people w/ HA have a cancerous tumor)
Supratentorial seizures are associated with which S/Sx?
Seizures (seizures are also associated with slower growing tumors)
Infratentorial seizures are most commonly associated with which S/Sx?
HA (more common with rapidly growing tumors)
Vomiting
Visual disturbances
Which region of the brain is mostly commonly affected in adults?
How about children?
Supratentorial –> ADULTS
Infratentorial –> Children
If there is a CNS lesion or tumor in the temporal lobe, what S/Sx would you expect to see?
SOLVE Temporal Tumor
Seizures Olfactory / Taste / Auditory impairment Lip smacking Visual Field defects Emotional changes
A PT presents with impaired stereognosis, inability to pay attention, and one-sided paresthesia; what lobe of the brain do you believe is suspect may have a tumor?
What is stereognosis?
Is the paresthesia ipsilateral or contralateral with respect to the tumor/lesion?
PARIETAL LOBE
Stereognosis –> ability to tell what an object is –> dorsal column and parietal lobe measurement
CONTRALATERAL PARESTHESIA
What are some RED FLAGS which require further neuroimaging?
What test would you order if a RED FLAG is present?
Acute NEW onset / severe HA
~~Esp. >50 y.o. PTs
HA progressive in nature or change in prev. pattern
Meningismus, fever, etc
HA w/ neurologic Sx
HA exacerbated / precipitated by val salva (bending over, coughing, sneezing)
ORDER MRI W/ CONTRAST
If tumor is found on MRI –> order CT chest/abd/pelvis to r/o metastases
T/F
A lumbar puncture is useful in diagnosis of a CNS tumor or lesion.
False
LP’s are NOT HELPFUL in Dx
Use MRIs w/ contrast
What is the associated Tx for a PT with a CNS / brain tumor?
Surg. resection
Radiotherapy / chemo
Shunting for hydrocephalus (divert XS CSF)
What is the associated Tx for a PT with a CNS / brain tumor?
Surg. resection
Radiotherapy / chemo
Shunting for hydrocephalus (divert XS CSF)
What non-invasive therapies could you Rx in conjunction to best manage your PT if surgery, chemo, and radiation are off the table?
Glucocorticoids to reduce peritumoral associated edema
(dexamethasone)
Analgesics (Simple or narcotics)
Anticonvulsants
~~Levetiracetam
~~Topiramate
~~Lamotrigine
Venous Thromboembolism prophylaxis (HEPARIN / LOVENOX)
What is the most common form of intracranial cancer?
Astrocytoma (Glioma)
What is a Meningioma?
Primary tumor which is an extra-axial mass attached to the dura
