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Flashcards in Brain tumors Deck (41):
1

Peak incidence of brain tumors in adults

74-84 yrs of age; avg age of onset is 54

2

Localizing symptoms of supratentorial tumors

Unilateral or migraine-type HAs, endocrine abnormalities, focal & generalized seizures, focal neurologic findings

3

Benign tumors

Do not invade nearby cells, tend to be circumscribed & well-differentiated, resemble cell of origin Can undergo malignant transformation & given their location, can become lethal

4

Anaplastic astrocytoma is most common in the

Cerebral cortex (adults), brainstem & cerebellum (children)

4

Effects of brain tumor chemotherapy treatment on CNS

WM particularly vulnerable Onset of changes may be delayed by months Evidence that chemo for non-cerebral tumors can impact functioning as well

5

Meningiomas are most common where?

Along the superior sagittal sinus, sphenoid ridge, & near optic chiasm

6

Most common sources for metastatic brain tumors

Lung (35-50%), breast (13-20%), melanoma (9-10%)

8

Most common brain tumors in adults

Glioblastoma & brain metastases; meningioma, schwannoma

8

Angioma

Congenital vascular malformation involving blood vessel proliferation that resembles a tumor

9

Short-term effects of chemotherapy for pediatric brain tumors

Drops in fine motor speed/coordination, performance on drawing/copying tasks

9

Radiation necrosis

Cerebral infarction from occlusion of small cerebral vessels that are damaged during high-dose radiation therapy for brain tumors; does not typically appear until approx. 6-18 mos after radiation therapy is complete

10

What types of cancers are most frequently associated with paraneoplastic syndromes?

Small cell lung, breast, testicular, ovarian

11

What type of chemotherapy is most common associated with neurocognitive effects in children?

High-dose IV cytarabine or methotrexate or intrathecal methotrexate

11

Olfactory groove meningioma

Tumor that originates in arachnoidal cells along the cribiform plate; may involve ipsilateral or bilateral anosmia & mental changes, including abulia, confusion, forgetfullness, & inappropriate jocularity

12

Effects of brain tumor radiation treatment on the CNS

Causes apoptosis in tumor cells & in non-tumor cells Dose-limited neurtoxicity is assoc. w/ spongiosis of the WM & vacular damage Can have both acute & delayed effects Impairements of memory & processing speed common

13

Predictors of poorer psychological outcome following pediatric brain tumors

Low child IQ, single parent family, low SES, higher family stress, mod-sev disfigurement, certain tumor locations, severe fx impairment

14

Paraneoplastic syndrome

Rare neurologic disorder caused by remote effects of cancer in the body leading to autoimmune response

16

CNS lymphoma is more common where?

Around ventricles

17

Risk factors for developmental stagnation after cranial irradiation

Younger age at time of treatment, higher dose of radiation, use of adjuvant therapies, higher baseline functioning = greater decline in overall IQ

18

Anaplasia

Loss of cell differentiation that is characteristic of most malignant tumors

19

What do declines in cognitive status with increasing time since radiotherapy treatment in children actually represent?

Stagnation in development rather than regression

21

Grade IV tumor

High-grade malignant tumor, rapid growth, high infiltration potential, not encapsulated, identified in multiple areas of brain, high recurrence potential

21

Academic outcome following pediatric brain tumor

57% have specific academic deficits, mostly arithmetic Those w/ hydrocephalus are particularly at risk Tx involving IT methotrexate & cranial RT either alone or in combo sig. increases likelihood for need of SPED services

23

Nonspecific signs of pediatric brain tumors

Developmental delays or regression, signs of increased ICP, increased fatigue, irritability, papilledema

24

Emotional distress following pediatric brain tumor

Mild withdrawal & social deficits in subset Significant parental distress & poor family functioning PTS symptoms are present in family members of survivors & less consistently in survivors themselves

26

GBMs are most common in the

Cerebral cortex

26

Radiation-associated encephalopathy

From radiation tx of tumors; associated with demyelination & necrosis; appears as subcortical dementia

27

Schwannomas are most common on

CN VIII

28

What is the most common type of paraneoplastic syndrome?

Limbic encephalitis w/ personality changes, memory loss Associated with non-systemic cancer, long/oat cell carcinoma, ovarian

29

Prognosis for metastatic brain tumors is better with the following factors

Better for age

30

Lambert-Eaton syndrome

Impaired presynaptic Ach release; paraneoplastic syndrome

32

Radiotherapy in children is associated with what NP effects?

Visual motor integration, verbal fluency, visual memory, exec fx (no single profile); relatively intact verbal memory & language skills

33

Malignant tumors

Anaplastic (cannot be clearly demarcated), usually proliferate rapidly, invade & destroy nearby cells

34

Ependymoma

CNS neoplasm made up of relatively undifferentiated ependymal cells (usu. from central canal of spinal cord)

35

Grade II tumor

Low grade malignant tumor, slowly growing, low infiltration potential, encapsulated but w/ poorly defined borders, greater potential for recurrence than I

36

Oligodendrogliomas are most common in the

frontal lobes

37

Common types of brain tumors in children

Low-grade astrocytomas, primitive neuroectodermal tumors (medulloblastoma most common), high-grade gliomas (more common in adults)

38

Grade I tumor

Low grade, slowly growing, low infiltration potential, encapsulated with clearly defined borders, tend not to recur

39

Treatment for brain tumors depends on what 3 factors?

Histological type, location, size

40

Grade III tumor

High-grade malignant tumor, rapid growing, high infiltration potential, poorly encapsulated, tend to recur

41

Localizing symptoms of infratentorial tumors

HA, nausea, persistent vomiting, balance problems & gait disturbances, signs of CN dysfx