Brain tumors

Question 1

S+S SOL

Answer 1

ICP - headache, vomiting, papilloedema
Seizures
Focal neurology
Personality changes

Question 2

Temporal lobe SOL

Answer 2

Dysphagia
Homonymous hemianopia
Amnesia
Odd phenomenon

Question 3

Frontal lobe SOL

Answer 3

Hemiparesis
Personality change
Broca’s dysphasia
Executive dysfunction

Question 4

Orbitofrontal syndrome SOL

Answer 4

Lack of empathy, over-eating, disinhibition

Over familiar

Question 5

Parietal lobe SOL

Answer 5

Hemisensory loss
Dysphagia
Gerstmann’s syndrome

Question 6

Occipital lobe SOL

Answer 6

Visual field defects
Palinopsia
Polyopia

Question 7

Cerebellum SOL

Answer 7

Dysdiadochokinesis
Ataxia
Slurred speech
Hypotonia
Intention tremor
Nystagmus

Question 8

Cerebellopontine angle SOL

Answer 8

Ipsilateral deafness
Nystagmus
Facial weakness
6th nerve palsy

Question 9

Pathology of schwannoma

Answer 9

Benign nerve sheath Schwann cell tumour

Associated with neurofibromatosis 2

Question 10

Complications of schwannoma

Answer 10

Becomes malignant

Left untreated can cause brainstem compression, cerebellar tonsil herniation, hydrocephalus

Question 11

S+S of schwannoma

Answer 11

Cochlear nerve = hearing loss, tinnitus
Vestibular nerve = walking disequilibrium
Trigeminal nerve = facial paraesthesia, pain
Facial nerve = facial paresis, gustatory disturbances

Question 12

Management of schwannoma

Answer 12

Excision

RT

Question 13

Pathology of glioblastoma

Answer 13

Highly malignant aggressive glial cell tumor

Usually in hemispheric white matter

Question 14

RF for glioblastoma

Answer 14

White males
Jews
Li Fraumeni
Tuberous sclerosis

Question 15

Complications of glioblastoma

Answer 15

Extension to ventricular wall
Meningeal gliomatosis
Mass effect
Seizures

Question 16

S+S of glioblastoma

Answer 16

Severe morning headache

Mental changes - altered mood, personality, impaired concentration

Question 17

Management of glioblastoma

Answer 17

Avastin
Surgery
Adjuvant chemo + RT

Question 18

Pathology of hemangioblastoma

Answer 18

Benign tumour, vascular cell proliferation

Cherry red cystic mass in cerebellum, spinal cord + brainstem

Question 19

RF for hemangioblastoma

Answer 19

Males 20-50

Von Hippel-Lindau

Question 20

Complications of hemangioblastoma

Answer 20

Acute hemorrhage
Tumor mass effect
Local structure compression
Paraneoplastic erythrocytosis

Question 21

S+S of hemangioblastoma

Answer 21

Brainstem = visual, sensory impairment + motor weakness
Cerebellum = ataxia
Spinal cord = pain, sensory impairment

Question 22

Management of hemangioblastoma

Answer 22

Antiangiogenic treatment (reduced EDGF production)
Surgery

Question 23

Pathology of meningioma

Answer 23

Tumor arising from meningeal arachnoid cells

Intracranial

Question 24

RF for meningioma

Answer 24

Neurofibromatosis 2 
Schwannomatosis 
MEN1
Ionising radiation 
Obesity 
Black
Females 
Older age

Question 25

Complications of meningiomas

Answer 25

Mass effect - obstructive hydrocephalus + raised ICP, herniation Reactive sclerosis, bone invasion Seizures

Question 26

S+S meningioma

Answer 26

``` Asymptomatic Visual impairment Impaired hearing Behavioural changes Muscle weakness ```

Question 27

Management of meningioma

Answer 27

Monitoring Surgery RT

Question 28

S+S of oligodendroglioma

Answer 28

Asymptomatic Seizures One-sided muscle weakness, impaired sensory perception, impaired memory Impaired language