Brain tumours

Question 1

Children usually get tumours in which location?

Answer 1

infratentorial

Question 2

Adults usually get tumours in which location?

Answer 2

supratentorial

Question 3

What type of tumours (primary or secondary) are more common in children?

Answer 3

primary

Question 4

Typical symptoms of brain tumours

Answer 4

neurological deficit
motor weakness
headaches
seizures

Question 5

Describe a tumour headache

Answer 5

severe, worse in morning, wakes them up, worse on coughing and leaning

Question 6

The mass effect of a tumour can lead to what?

Answer 6

raised ICP and herniation of brain

Question 7

symptoms of raised ICP

Answer 7

headaches, vomiting, blurred vision/ papilledema, confusion

Question 8

what kind of brain herniation is most common?

Answer 8

uncal herniation

Question 9

Most common type of primary brain tumour?

Answer 9

astrocytic tumours

Question 10

Is grade 1 astrocytoma benign or malignant?

Is it fast or slow growing?

Answer 10

benign and sloe growing

Question 11

who are more likely to get grade 1 astrocytoma’s

Answer 11

children, young adults

Question 12

symptoms of grade 1 astrocytoma?

Answer 12

raised ICP with associated symptoms, seizures (gelastic seizures - uncontrolled laughing)

Question 13

investigation of choice for grade 1 astrocytoma?

Answer 13

enhances like a lightbulb on CT

Question 14

treatment of grade 1 astrocytoma?

Answer 14

surgery - curative

Question 15

define grade 2 astrocytoma

Answer 15

low grade, benign - but can de-differentiate to high grade

Question 16

investigations for grade 2 astrocytoma

Answer 16

doesn’t enhance well on CT - MRI better

Question 17

treatment for grade 2 astrocytoma?

Answer 17

surgery and molecular profiling

radiation and PCV (triple chemo) if too large

Question 18

what is a grade 3 astrocytoma?

Answer 18

anaplastic astrocytoma - malignant

Question 19

prognosis of grade 3 astrocytoma

Answer 19

median survival 2 years

Question 20

what is grade 4 astrocytoma?

Answer 20

glioblastoma multiforme

very aggressive

Question 21

prognosis of glioblastoma?

Answer 21

median survival 14 months

Question 22

what is the most common type of primary tumour in adults?

Answer 22

glioblastoma multiforme

Question 23

treatment for grade 3 and 4 astrocytoma

Answer 23

non-curative surgery to improve QoL (reduce mass effect, seizures) + radiotherapy + TMZ (chemo)

Question 24

what safety factor is important for those with brain tumours?

Answer 24

They can drive due to seizure risk

Question 25

what is a glioma?

Answer 25

malignant brain tumour originating from astrocytes and oligodendrocytes - they include astrocytoma's and oligodendroglioma

Question 26

what is an oligodendroglioma

Answer 26

tumour arising from oligodendrocytes low or high grade slow growing May become calcified

Question 27

treatment and prognosis of oligodendroglioma

Answer 27

surgery and chemo (PCV) +/- radiotherapy | median survival 10 years (low grade)

Question 28

what is a meningioma

Answer 28

mostly benign, slow growing tumours arising from arachnoid membrane and granulations may grow to a large size over many years

Question 29

who are more likely to get a meningioma

Answer 29

women> men | 50s

Question 30

common presentation of a meningioma

Answer 30

headache - as dura has nerve supply

Question 31

treatment and prognosis of meningioma?

Answer 31

surgery and radiotherapy small non growing meningiomas do not need to be operated on can recur depending on grade and resection most survive long term (5 year survival 90%)

Question 32

what is a vestibular schwannoma

Answer 32

benign nerve sheath tumour - arising from Schwann cells

Question 33

vestibular schwannomas are a common finding in which condition

Answer 33

neurofibromatosis type 2

Question 34

symptoms of a vestibular schwannoma

Answer 34

hearing loss, tinnitus, balance problems

Question 35

Treatment of vestibular schwannoma?

Answer 35

if large remove by surgery as can compress brainstem - surgery is high risk if small leave alone malignant transformation is rare

Question 36

what are pituitary tumours?

Answer 36

benign tumours that may be functioning or non functioning

Question 37

how does a pituitary tumour present?

Answer 37

headaches, bitemporal hemianopia if compressing optic chiasm, endocrine abnormalities

Question 38

what condition can arise from a functioning pituitary tumour?

Answer 38

Cushing's