CNS: Brain Tumours and Head Injuries Flashcards

1
Q

How many brain tumours are primaries?

A

50%

50% are metastatic

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2
Q

Primary tumours that often metastasise to brain?

A
Lymphoma
Breast
Lung
Prostate
GI tract
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3
Q

Potential symptoms of a brain tumour (5)

A

Depends on the part of the brain they occupy

  • New epilepsy
  • Hydrocephalus
  • Focal neurology deficit
  • Balance or gait problems
  • Visual defects in pituitary tumour
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4
Q

How are brain tumours different to other tumours?

A

Can cause death even if benign by raising ICP, pushing brain stem, and pressing on adjacent structures

Made worse by oedema and haemorrhage

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5
Q

First line investigations for brain tumour

A

CT or MRI

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6
Q

Where do gliomas arise from?

A

From supporting neuroglia (includes astrocytomas, oligodendrogliomas, ependymomas)

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7
Q

Where do neuroblastomas arise from?

A

Neurones

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8
Q

Where do meningiomas arise from?

A

Meninges

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9
Q

Where do Shwannomas or neurofibromas arise from?

A

Cranial nerves

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10
Q

Definitive diagnosis of brain tumour?

A

Histology from brain biopsy or brain smear

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11
Q

Treatment of brain tumour

A

Surgery but site is important

Chemoradiotherapy but only specific options which can cross BBB. Also lots of side effects on brain function, cognition, vision

Proton beam therapy

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12
Q

True/false: Primitive neuroectodermal tumours are slow growing tumours most commonly seen in YAs

A

False, they are rapidly growing tumours in children

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13
Q

True/false: Most brain tumours in children are in the posterior fossa

A

True, over 70%

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14
Q

True/false: meningiomas are associated with alterations in gene locus at 22q12

A

True, this is the neurofibromatosis 2 gene

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15
Q

True/false: Astrocytomas can be recognised by Glial Fibrillary Acidic Protein (GFAP) positivity on IHC

A

True

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16
Q

True/false: Orimary lymphomas of the CNS are linked with immunosuppression and are usually B cell in origin

A

True

17
Q

Types of diffuse head injuries?

A

Diffuse axonal
Diffuse vascular
Hypoxic ischaemic damage
Diffuse brain swelling

18
Q

Abrasion

A

Scratch/graze

19
Q

Laceration

A

Cut/tear

20
Q

Incisions

A

Slashes

21
Q

Stab wounds

A

Penetrating wounds

22
Q

Black eye

A

Orbital contusion

23
Q

Causes of a black eye (3)

A
  1. Direct blunt force to the orbit
  2. Injury to the front of the scalp (blood tracks downward)
  3. Fracture of the base of skull superio-posterior to eye, causing raccoon eyes
24
Q

Linear skull fracture

A

May be due to blunt impact, appears as a line on skull surface or within the base

25
Q

Comminuted fracture

A

When an impact shatters the skull into multiple pieces

26
Q

What injury can a hammer cause to the skull?

A

Circular depressed fracture

27
Q

Hinge fracture

A

A fracture across the base (or any part) of the skulls where two pieces move relative to one another

May be caused by fall or RTC

28
Q

Coup

A

COntusion beneath impact