Flashcards in Brain tumours Deck (24):
What does glioma mean?
tumour from glial cell. They are neuroepithelial cells
what are some inherited or genetic conditions are predisposing to brain cancer?
Neurofibromatosis 1 and 2
and Li Fraumeni syndrome.
But rare to have a family history- so genetic history often not a risk factor.
Why do you get ICP headache in the morning?
Venous return is slower in the supine position. You also get hypercapnic at night leading to further vasodilation and further blood in the head. When you stand up the venous blood returns to the heart. You also vomit, which leads to hyperventilation. This reduces CO2 and hence vasoconstriction occurs. This alleviates the headache.
If you cough or strain the headache is exacerbated bc you are still increasing venous blood in the head.
where is the headache due to ICP?
all over the head. Not focal or unilateral
what grade is glioblastoma multiforme?
WHO grade 4 glioma
what is the WHO grade for anapaestic astrocytoma?
WHO grade 3
what is the percentage of all brain tumours is gliomas?
why might you not get a focal neurological deficit?
lesion might be in a part of the brain which doesn't code for focal neurological signs. E.g. personality in the frontal lobe.
what is the presentation of an intracranial tumour?
Symptoms of raised ICP
Focal neurological deficit
Duration of symptoms depends on rate of growth of mass
what is the Monro Kelli doctrine graph?
Pressure vs volume graph. Pressure doesn't go up immediately as volume increases due to intracranial tumour. Eventually you'll get to a critical volume that pressure increases exponentially.
where would the lesion be if you get mood disturbances or personality changes?
where would the lesion be if a patient presented with limb weakness?
motor cortex in posterior frontal lobe, internal capsule, brainstem
where would the lesion be if a patient presented with dysphasia?
dominant frontal or temporal lobe
what do we use to medically treat brain tumours?
dexamethasone- reduction of cerebral oedema and ICP
what do we use as adjuvant therapy?
radiotherapy and chemotherapy (temozolomide)
can surgical resection cure a malignant brain tumour?
Not really. All it does is really reduce the symptoms of mass effect and increase extent of survival.
what sort of things are you looking for on neurological examination?
focal neurological signs, signs of a seizure, papilloedema, etc.
what consists of a low grade glioma?
oligodendroglioma, astrocytomas and mixed forms.
do you still do biopsy for a low grade glioma?
where do we see metastases in the brain?
in end vessels.
which is more associated- cerebral oedema with metastasis in the brain or cerebral oedema with primary brain tumours?
where does a meningioma arise from?
arise from arachnoid cells in the meninges. can be associated with intense oedema
is a meningioma benign or malignant?