Brain tumours

Question 1

where do meningiomas arise form

which part of the brain are they found in

Answer 1

meninges (dura)

the outside bit (where the dura is) = next to the skull

Question 2

are meningiomas usually benign or malignant

Answer 2

benign (99%)

Question 3

what is the pneumonic for malignant meningiomas

Answer 3

CCRaP

Clear cell
Choroid
RhAbdoid
Papillary

Question 4

common cause of malignant meningiomas

Answer 4

post radiotherapy (eg got radiotherapy as a kid)

Question 5

presentation of meningiomas

Answer 5

asymptomatic (bc most benign)
?CN neuropathies
raised ICP symptoms - headache, blurred vision

Question 6

investigtaions for ?meningioma

Answer 6

CT, MRI

Question 7

CT appearance of meningioma

Answer 7

‘skull blistering’

Question 8

MRI appearance of meningioma

Answer 8

dural tail

patent dural sinuses

Question 9

meningioma treatment

Answer 9

surgery

?chemo if symptomatic

Question 10

most common type of extrinsic brain tumour (outwith the brain tissue)

Answer 10

meningioma

Question 11

which extrinsic brain tumour is associated with neurofibromatosis and presents with hearing loss

Answer 11

acoustic neuroma

Question 12

where is the tumour in acoustic neuromas

Answer 12

nerve sheath of CN VIII

Question 13

what is the most common type of intrinsic brain tumour (within the brain itself)

Answer 13

metastasis

Question 14

grade I intrinsic brain tumour name (1)

Answer 14

pilocytic astrocytoma

Question 15

who get grade I intrinsic brain tumours (pilocytic astrocytoma)

are they curable
via what method of treatment

Answer 15

kids/young adults

yes high cure rate via surgery

Question 16

grade II intrinsic brain tumour name (2)

Answer 16

diffuse astrocytoma

oligodendroglioma

Question 17

why MUST grade II/III tumours be removed

Answer 17

can progress to glioblastomas (grade IV tumours)

Question 18

grade III intrinsic brain tumour name (1)

Answer 18

anaplastic astrocytoma

Question 19

grade IV intrinsic brain tumour name (1)

Answer 19

glioblastoma multiforme (GBM)

Question 20

as you progress from grade I to grade IV intrinsic brain tumors, does prognosis improve or decrease

Answer 20

decreased
grade I curable
grade IV <1year survival

Question 21

prognosis of grade IV intrinsic brain tumour (glioblastoma)

Answer 21

<1 year

Question 22

who get glioblastomas (grade IV intrinsic brain tumour)

Answer 22

elderly

Question 23

what type of intrinsic brain tumour has calcification on MRI

what grade is it

Answer 23

oligodendroglial cell tumour

grade II (same as diffuse astrocytoma)

Question 24

in which lobe do oligodendroglial tumours occur

hence present with what symptom

Answer 24

frontal lobe

seizures

Question 25

which type of brain tumour is benign, highly vascular and associated with hippel-landau syndrome (renal carcinomas, phaemochromocytoma)

Answer 25

haemangioblastoma

Question 26

how does a cerebellar tumour present (7) which side - ipsilateral or contralateral

Answer 26

DANISH ``` dysdiadochokinesis ataxia - broad based gait nystagmus - do H test intention tremor - do finger to nose test slurred speech hypotonia - reduce tone ``` ipsilateral

Question 27

how does a temporal lobe tumour present

Answer 27

seizures memory deficits wernickes aphasia contralateral superior quadrantanopia

Question 28

how does a frontal lobe tumour present

Answer 28

``` personality changes brocas aphasia (expressive aphasia) hemiparesis - note motor not sensory bc motor is more anterior in the brain than sensory = frontal lobe ```

Question 29

how does a parietal lobe tumour present

Answer 29

hermisensory loss - note sensory note motor bc motor Is more anterior in the brain = frontal lobe gertsmann syndrome - inability to write (dysgraphia), difficulty understanding maths, R/L confusion

Question 30

which lobe does a tumour in cause difficulty understanding maths, inability to write (dysgraphia) amd L/R disorientation what is this called

Answer 30

parietal lobe tumour gertsmann syndrome

Question 31

how does an occipital lobe tumour present

Answer 31

visual hallucinations | contralateral homonymous hemianopia

Question 32

as well as specific symptoms depending on where the tumour is, what symptom Is associated with the headache what makes the headache worse

Answer 32

headache associated with vomiting headache worse on coughing

Question 33

investigations for ?brain tumour

Answer 33

MRI biopsy fundoscopy - for papilloedema

Question 34

which investigation is diagnostic of the type of brain tumour

Answer 34

biopsy - MRI just confirms theres one there

Question 35

which investigation is used to confirm there is a brain tumour present

Answer 35

MRI

Question 36

what is given to patients acutely with ?brain tumour with raised ICP

Answer 36

mannitol

Question 37

treatment of all brain tumours

Answer 37

surgery to remove it +/- radiotherapy +/- chemo just surgery fine if benign and low chance of recurrence/progression to malignancy

Question 38

what tpe of chemo is used for brain tumours

Answer 38

temozolomide (TMZ)

Question 39

what is the first line treatment for oligodendroglial tumours

Answer 39

chemo - temozolomide (TMZ)

Question 40

cerebellar tumoru ipsilateral or contralateral

Answer 40

ipsilateral problems

Question 41

everything but cerebellar tumour ipsilateral or contralateral

Answer 41

contralateral

Question 42

3 types of brain cancer in kids which is more common

Answer 42

astrocytoma - common pineal tumours - rare germ cell tumours

Question 43

how do kids with astrocytomas present

Answer 43

tiptoeing gait | vomiting with headache

Question 44

treatment of astrocytoma in kids

Answer 44

surgery

Question 45

where is a pineal tumour | how does it look on MRI

Answer 45

in the pinea - just behind the lateral ventricles on MRI - looks like sugar coating on pinea