Flashcards in Intracranial & CNS Tumours Deck (27):
What are symptoms of raised intracranial pressure?
-Headaches (early morning)
What are the causes of raised intracranial pressure?
What neurological deficits are there?
What neuro causes are there for seizures?
-Partial/complex partial/secondary generlaized
What investigations are used for suspected intracranial tumours?
-Tumour markers (PSA, Bhcg, aFP)
What can an fMRI identify?
-Measures brain activity by detecting changes associated with blood flow
-Speech lateralised to left hemisphere
-Bilateral hand movements by bilateral motor cortex
How are intracranial tumours managed?
-Medical: steroids, anti-convulsants, hormonal replacement, anti-epileptics, radio/chemo
-Surgical: remove mass effect, biopsy (free hand, endoscopic, neuro-navigation, stereotactic), excision (total/partial)
What is a frozen section?
-Confirm abnormal tissue
-Difficult to establish for some intrinsic tumours
-Oedema surrounding tumour may look abnormal
-Tumour resection can proceed
What are complications of surgery?
-Hydrocephalus- third ventriculostomy, ventricle-peritoneal shunt
What CNS tumours are most common in males & females?
What are the types of glial cells and what are their functions?
-Astrocytes (support & protect)
-Ependymal cells & choroid plexus cells (CSF)
What tumours can arise from nervous tissue?
What is the histological criteria for malignancy in brain tumours?
-Cellular density & atypia
What are microscopic features of astrocytic tumours?
-Fine fibrillary & microcystic background
-Inc cellular density
Describe the features of a diffuse astrocytoma and its grade
-Infiltrative, microcystic, fibrillary
-Low cellular density
-No mitotic activity
Describe the features of a anaplastic astrocytoma and its grade
-Moderate cellular density
Describe the features of a glioblastoma and its grade
-High cellular density & mitoses
Describe the features of pilocytic astrocytoma and its grade
-Well defined cystic
Describe the features and grade of an oligodendroglioma
-Round uniform nuclei with clear cytoplasm (fried egg)
-Arborising capillaries (chicken wire)
Describe the features and grade of an ependymoma
-Round, small uniform cells
Describe the features and grade of a meningioma
-Well defined extra axial
Describe the features and grade of a PNET
-Very high cellular density
-Anaplastic hyperchromatic cells
-Frequent mitoses & apoptosis
Name some nerve sheath tumours
-Schwannoma (CN8, reticulin, biphasic pattern)
-Neurofibroma (spinal nerves rich in collagen)
What are the causes of:
-NF1/2= Familial syndromes
What 4 markers are relevant for molecular diagnosis of gliomas?
-MGMT promoter methylation
What are side effects of cranial radiotherapy?
-Acute= hair loss, scalp/ear erythema, cerebral oedema-raised ICP & exacerbation of neuro symptoms
-Intermediate= somnolence syndrome-severe tiredness & exacerbation of neuro symptoms
-Late= damage to sensitive structures-lens/cataracts, pituitary (hypopituitarism), cerebral hemispheres (memory loss)