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CNS > 1. Brain Tumours > Flashcards

1. Brain Tumours Flashcards

1
Q

What proportion of brain tumours are secondary?

A

15%

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2
Q

What are the most common cancers that met to the brain?

A

Lung

Breast

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3
Q

What is the presentation of brain tumours?

A

Seizures
Signs of raised intracranial pressure
Hydrocephalus
Focal neuro deficits

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4
Q

What are the signs and symptoms of raised ICP?

A

Postural headache: early morning and late night
Vomiting
Papilloedema
Clouding of consciousness

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5
Q

What are the 2 types of cerebral oedema?

A

Vasogenic due to vessel damage: increased intercellular fluid
Cytotoxic due to damage to cells: increased intracellular fluid

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6
Q

What does brain swelling result in?

A

Compression of vessels > vascular insufficiency > cytotoxic oedema worsening ICP > herniation

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7
Q

What are the types of cerebral herniation?

A 
Subfalcine
Transtentorial
Transforaminal
Upward herniation of cerebellum
Craniectomy
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8
Q

What is a subfalcine herniation?

A

Cingulate gyrus under the falx cerebri

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9
Q

What is compressed in a subfalcine herniation?

A

Anterior cerebral artery

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10
Q

What is a transtentorial herniation?

A

Temporal lobe uncus through the tentorium

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11
Q

What is compressed in a transtentorial herniation?

A

CN3
Posterior cerebral artery
Corticospinal tracts in midbrain

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12
Q

What is hydrocephalus?

A

Increased CSF volume within the ventricular system

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13
Q

What are the causes of hydrocephalus?

A 
Neoplasm interfering with flow
Malformation of CSF tract
Infection causing scarring
Haemorrhage
Giosis
CSF overproduction
Failure of CSF absorption
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14
Q

Name 2 tumours causing hydrocephalus

A

Posterior fossa tumours

Pineal gland neoplasm

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15
Q

What are the symptoms and signs of hydrocephalus in infants?

A 
Enlarged head
Bulging fontanelle
Vomiting
Irritability
Sleepiness
Downward eyes
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16
Q

What are the symptoms and signs of hydrocephalus in children?

A

Headache
Blurred vision
Poor balance
Seizures

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17
Q

What are the symptoms and signs of hydrocephalus in adults?

A

Memory loss

Bladder control problems

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18
Q

What is the most common benign tumour of the brain?

A

Meningioma

19
Q

What is the most common malignant tumour of the brain?

A

Gliomas

20
Q

What stain is associated with atypical teratoid rhaboid tumour?

A

INI1

21
Q

What is the most common glioma?

A

Glioblastoma

22
Q

What method of spread is used by gliomas?

A

Secondary structures of Scherer

23
Q

What is the prognosis of a brain tumour based on?

A

Grade predicts behaviour

Site is very important: resection, involvement of ‘eloquent areas’

24
Q

Give an example of a grading system

A
  1. is a tumour
  2. no high grade features
  3. mitosis
  4. vascular proliferation +/- mitosis
25
Q

What are the methods of molecular neuropathology?

A

aCGH
DNA sequencing panels
Methylation
Fusion specific qPCR

26
Q

What is the role of molecular neuropathology?

A

Make a diagnosis
Indicate grade
Predict response to therapy
Predict behaviours

27
Q

What radiology is used for brain tumours?

A

CT

MRI with contrast

28
Q

What is the treatment for brain tumours?

A

Gross total resection

+/- radio and chemo therapy

29
Q

What mutation gives a poor prognosis in a glioma?

A

H3K27M

30
Q

What does a ‘fried egg’ appearance suggest?

A

1p19q co-deletion: defines oligodendroglioma

Responds to PCV therapy

31
Q

Which cancer is a BRAF gene fusion seen in?

A

Posterior fossa pilocytic astrocytomas

32
Q

What does a BRAF gene mutation V600 indicate?

A

Tumour may respond to BRAF inhibitor therapy

eg. Vemurafenib

33
Q

What does an IDH mutation suggest?

A

Better prognosis in glioma

34
Q

What does MGMT methylation indicate?

A

Responsiveness to temozolamide in gliomas

35
Q

What does histone mutation suggest?

A

Automatic high grade tumour; very bad prognosis

36
Q

What tumours are related to NF type 1?

A

Neurofibroma

Optic pathway gliomas

37
Q

What tumours are related to NF type 2?

A

Schwannoma

Epenymoma

38
Q

What tumour is related to von Hippel Lindau disease?

A

Haemangioblastoma

39
Q

What tumour is related to tuberous sclerosis?

A

Subependymal giant cell astrocytoma

40
Q

What tumours are related to Li Fraumeni syndrome?

A

Glioma
Embryonal
Choroid plexus tumour

41
Q

What tumour is related to Cowden syndrome?

A

L’hermitte duclos

42
Q

What tumour is related to Turcot sydrome?

A

Glioma

43
Q

What name is given to haemorrhage in the brainstem due to herniation?

A

Duret haemorrhage

CNS (21 decks)

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