Intracranial Tumours Flashcards
(21 cards)
Which cranial nerves are usually affected by true localizing deficits in intracranial tumours?
CN III & VI
What is the most common presentation of intracranial tumours?
Focal neurological deficit
Either cranial nerve, lobar or brainstem
Which cranial nerves are associated with the cavernous sinus, and are therefore affected by tumours in the cavernous sinus region?
CN III, IV, V1, V2 & VI
What deficits are seen in tumours affecting the temporal lobe?
Receptive (Wernicke’s) aphasia
Memory problems
Auditory problems (Heschl’s gyrus = primary auditory centre)
Superior quadrantalopia
What is Heschl’s gyrus in the temporal lobe?
Primary auditory centre
What is Gerstmann’s syndrome?
Dysgraphia, dyslexia, dyscalculia, finger-nose agnosia
Seen in tumours affecting dominant parietal lobe
What is seen in patients with tumours affecting the dominant parietal lobe?
Gerstmann’s syndrome
Dysgraphia, dyslexia, dyscalculia, finger-nose agnosia
What is seen in patients with a tumour affecting the non-dominant parietal lobe?
Visuospatial problems
Apraxia
Inattention/neglect
Contralateral inferior quadrantalopia
What problems are seen in patients with tumours affecting the frontal lobe?
Expressive dysphasia (only if affecting Broca’s in dominant lobe)
Executive function (attention, decision-making, emotions, personality)
What is important about the cerebellum’s infratentorial location?
It means cerebellar signs are ipsilateral
What cerebellar signs are seen in patients with tumours affecting that region?
Ataxic gait
Action tremor
Jerky irregular movements
Ipsilateral signs
What cranial nerves are associated with the pontomedullary junction?
CN V, VI & VII
What are the characteristics of an increased ICP headache?
Worse in the morning
Exacerbated by bending/stooping
Bilateral, often global
Not severe
What is the treatment of a prolactinoma?
Bromocriptine
Dopamine agonist
Dopamine exerts negative feedback on prolactin & shrinks tumour)
What is the most common intracranial tumour?
Metastatic tumour
Bronchus and breast most common
What are the most common primary intracranial tumours in adults?
Meningioma (25%) Pituitary adenoma (25%)
What does irregular contrast enhancement of a lesion seen on a CT scan indicate?
Malignant astrocytoma
What does homogenous enhancement of a lesion seen on a CT scan indicate?
Meningioma
What is the difference between radiosurgery and radiotherapy in the management of intracranial tumours?
Radiotherapy = fractionated (multiple) treatments
Radiosurgery = one-off radiation treatment
What visual defect is caused by pituitary tumours?
Bitemporal hemianopia
Compression of nasal fibers decussating at the optic chiasm
Of what is depression of the corneal reflex an early sign?
Acoustic neuroma in CPA
due to 5th nerve compression
