Brain Tumours

Question 1

What is SOL ?

Answer 1

Any space that occupying lesion like tumour, hydatic cyst , hematoma , abscess , arachnoid cyst

Question 2

🔘CPP ( cerebral perfusion pressure) depends on what?
🔘Normal range of ICP ?
🔘Why BP increase in ⬆️or⬇️ ICP?

Answer 2

☑️ cpp= ICP — mean arterial pressure
☑️ 16-20
☑️ to maintain perfusion to brain , it just compasatary mechanisms

Question 3

What is clinical presentation in pt with ⬆️ ICP ?
Why dilated pupil happend ?

Answer 3

🔘By sign and symptoms:
✔️headache
✔️ nausea/vomiting
✔️ LOC
✔️epilepsy
✔️sided weakness
✔️dilated pupil🔺

🔘 due compression on cranial n. ( optic n.)
It is important sign to know if pt have SOL

Question 4

What is the commonst brain tumour?why?

Answer 4

Glioma tumor due diffuse glial cell in spine and brain

Question 5

Enumerat benign brain tumours? Difition of each tumor?

Answer 5

✔️Meningioma:
Tumor that arises from meninges ( membrane that surrounds brain and spine)

✔️craniopharigioma:
Occurs mostly in children
Rare type of tumor that derived from pituitary gland

✔️epindimoma:
Begins in ependymal cell that line ventricales in brain and central canal in spinal cord

✔️vistbular schwannoma ( Acoustic neuroma):
Develops on main vestibular n.
Arises from Schwann cell that covers this nerve
This tumor growing slowly
Effect the balance hearing pressure and ringing in the end loss of hearing…

✔️Dermoid cyst ؛
Occurs when tissue collects under the skin
Usually harmless and removed bu surgery

✔️glioma ( benign type)
Mostly benign in spine (grade 1)

Question 6

Enumera malignant types of brain tumor ?

Answer 6

☑️ glioma ( malignant type)
Most common in adults

☑️ medulloplastoma
Most commonly in paediatrics
Starts in cerebellum
Effect brain stem (respiratory center compressions )so it need surgery
Clinical presentation is syncope

☑️ lymphoma
Most common in immune compromised

Question 7

Enumera metastasis brain tumor?

Answer 7

1) Lung
2) breast
3) liver
4) thyroid
5)bone

Question 8

What is the common organism that causes brain abscess?

Answer 8

Staphylococcus aureus

Question 9

What is most common source of brain abscess?

Answer 9

Para nasal sinus, otitis media ,penetrating head injuries,post op

Question 10

What is common presentation of brain abscess?

Answer 10

Loss of consciousness, fever , sign of rise ICP

Question 11

Treatment for brain abscess ?

Answer 11

Antibiotics ( like sephalosporin)
Surgery ( drainage)

Question 12

Causes of brain hydatid cyst?
Symptoms?
Treatment?

Answer 12

Caused by Echinococcus granulosus
Symptoms: signs of rise ICP
Treatment: surgery

Question 13

What is brain Arachnoid cyst?

Answer 13

Is csf covered by arachnoid cell and collagen buildup between arachnoid membrane and surface of the brain

Question 14

Manegmant of increased ICP?

Answer 14

☑️ medical treatment:
• Head elevation : reduced pressure due gravity
• High flow O2 : to prevent vasoconstriction
• Manitol : hypertonic solution ( osmolarity will absorb odema)
• Dexamethasone : improves blood vessels and BBB in brain
Hypertonic Na
• ACEi :( diamox ) will reduce ranin angiotensin system this will reduce production of CSF

☑️surgical treatment:

• Craniotomy
• Endoscopic
• Radio surgery ( GAMMA KNIFE)
• Robotic

Question 15

What is hydrocephalus?

Answer 15

Accumulation of CSf inside the brain leads to increased ICP

Question 16

Types of hydrocephalus?

Answer 16

1) communicating hydrocephalus:
That occurs due accumulation of csf inside ventricles due to failed absorption of csf through arachnoid granulation

2) non communicating hydrocephalus: