Brain Tumors

Question 1

What are the two main types of brain tumors?

Answer 1

Brain tumors may be primary or metastatic.

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Question 2

What is Astrocytomas?

Answer 2

Astrocytes are the most common CNS glial cells

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Question 3

What are Gliomas?

Answer 3

• Gliomas are primary brain tumors
• least aggressive
• Often found in young adults w/new onset seizures

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Question 4

What is Pilocyctic astrocytomas?

Answer 4

• Mostly benign
• good outcomes if resectable
• found in children & young adults

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Question 5

What is Anaplastic astrocytomas?

Answer 5

• Usually evolve into Glioblastoma Multiforme
• Poorly differentiated

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Question 6

What is Glioblastoma Multiforme?

Answer 6

• Carry a high mortality
• Usually requires surgical debulking & chemo
• Life expectance is usually within weeks, even w/treatment

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Question 7

What are Meningiomas and how often do they occur?

Answer 7

Benign tumors that arise from dura or arachnoid tissue.

Good prognosis w/surgical resection

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Question 8

What are pituitary adenomas and their prevalence?

Answer 8

Pituitary adenomas are noncancerous, varying subtypes

Transsphenoidalor open craniotomy for removal is usually curative

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Question 9

What are Acoustic Neuromas?

Answer 9

• Usually benign schwannomas involving the vestibular component of CN VIII within the auditory canal
• Good prognosis w/resection +/- radiation

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Question 10

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What are metastatic carcinomas in the context of brain tumors?

Answer 10

• can vary widely in origin &symptoms​
• Outcomes are generally less favorable

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Question 11

What should be reviewed during pre-anesthesia for a patient with a brain tumor?

Answer 11

• Review the patient’s history
• physical
• previous therapies
• presenting symptoms
• neurological deficits

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Question 12

What effect can radiation have on patients with brain tumors?

Answer 12

Radiation damage may lead to lethargy and altered mental status (AMS).

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Question 13

What are potential neurological effects of chemotherapy in patients with brain tumors?

Answer 13

Chemotherapy may also have neurological effects.

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Question 14

Why are patients with brain tumors often on steroids before surgery?

Answer 14

to minimize cerebral edema.

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Question 15

What is important to monitor when continuing steroids in brain tumor patients?

Answer 15

to monitor glucose levels.

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Question 16

How may autonomic dysfunction manifest in brain tumor patients and what should be monitored?

Answer 16

Autonomic dysfunction may manifest on EKG, with labile heart rates and blood pressures.

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Question 17

Why are anticonvulsants commonly used in patients with brain tumors?

Answer 17

Anticonvulsants are common, especially for those with supratentorial lesions.

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Question 18

What tests should be performed preoperatively for brain tumor patients?

Answer 18

• CBC
• BMP (especially glucose)
• EKG
• CT/MRI

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Question 19

What medications should be managed preoperatively for brain tumor patients according to the surgeon’s instructions?

Answer 19

pre-operative steroids and anti-seizure medications per the surgeon’s instructions.

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Question 20

What is Mannitol’s role in the preoperative management of brain tumor patients?

Answer 20

used to reduce intracranial volume and pressure preoperatively.

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