Intracranial Tumours

Question 1

Primary intracranial neoplasms are the 2nd most common tumours in children. True/False?

Answer 1

True

Question 2

List the typical clinical presentations/symptoms of intracranial neoplasms

Answer 2

Neurological deficit
Motor weakness
Headache
Seizures

Question 3

List clinical presentations/symptoms of raised intracranial pressure

Answer 3

Headache
Vomiting
Mental changes
Seizures
Visual impairment

Question 4

Neurological signs of tumours correlate with anatomical location and function. List the features associated with the frontal lobe

Answer 4

Executive function
Brocas area
Precentral motor area 
Memory 
Smell

Question 5

Neurological signs of tumours correlate with anatomical location and function. List the features associated with the temporal lobe

Answer 5

Behaviour
Memory
Hearing and vision
Emotion
Understanding speech

Question 6

Neurological signs of tumours correlate with anatomical location and function. List the main features associated with the parietal lobe

Answer 6

Sensation

Understanding speech

Question 7

Neurological signs of tumours correlate with anatomical location and function. List the main feature associated with the occipital lobe

Answer 7

Vision

Question 8

List the main investigations that may be done for suspected intracranial neoplasms

Answer 8

CT
MRI +/- contrast (better for posterior fossa masses)
Lesion biopsy
Angiography

Question 9

Describe WHO grade I astrocytic tumours

Answer 9

Pilocytic (hair like), slow growing

Question 10

Describe WHO grade II astrocytic tumours

Answer 10

Low grade astrocytoma (diffuse)

Question 11

Describe WHO grade III astrocytic tumours

Answer 11

Anaplastic astrocytoma

Question 12

Describe WHO grade IV astrocytic tumours

Answer 12

Glioblastoma multiforme

Question 13

Who is typically affected by grade I astrocytic tumours?

Answer 13

Children
Young adults
Typically headache with vomiting and low appetite

Question 14

What is the treatment of choice for grade I astrocytic tumour?

Answer 14

Surgery (curative)

Question 15

Grade II astrocytic tumours (low grade astrocytoma) have predilection for which brain lobes?

Answer 15

Temporal
Posterior frontal
Anterior parietal

Question 16

List poor prognostic factors for low grade astrocytomas

Answer 16

Age over 50
Focal deficit
Short duration of symptoms
Raised ICP
Altered consciousness

Question 17

Outline treatment options for low grade astrocytomas

Answer 17

Radio/chemo -therapy

Surgery

Question 18

Which carries poorer prognosis - anaplastic astrocytoma or glioblastoma multiforme?

Answer 18

Glioblastoma multiforme (1 year)
Anaplastic astrocytoma (2 years)

Question 19

Which lobe do oligodendroglial tumours predominately affect?

Answer 19

Frontal lobe

Question 20

Describe the morphology of oligodendroglial tumours (buzzword)

Answer 20

Grayish-pink

Toothpaste-like

Question 21

What is median survival for oligodendroglial tumours?

Answer 21

10 years

Question 22

What % of intracranial tumours are meningiomas?

Answer 22

20%

Question 23

Majority of meningiomas are asymptomatic. True/False?

Answer 23

True

Question 24

What is meningioma en plaque?

Answer 24

Subtype of meningiomas that infiltrate dura and sometimes bone
Carpet/sheet-like lesions

Question 25

Meningiomas are usually malignant. True/False?

Answer 25

False
Histologically benign (90%)

Question 26

Outline treatment of meningioma

Answer 26

Pre-operative embolization

Surgery

Question 27

What do pineal tumours typically obstruct?

Answer 27

CSF outflow, leading to hydrocephalus