Lecture 65: Brain tumors Flashcards Preview

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Flashcards in Lecture 65: Brain tumors Deck (41):
1

Brain tumors w/ headache (%); w/ JUST headache (%)

30%; 1%

2

T/F: Primary brain tumors are usually metastatic

False

3

Worst brain tumor; what grade/cell type? Survival? Histology?

Glioblastoma multiforme; grade IV astrocytoma; median = 1 year; pseudopalisading

4

Most common primary brain tumor?

Glioma

5

Describe glial resection

Difficult; but if low grade complete resection is better than debulking alone

6

What is a butterfly glioma? Operable?

Glioma that crosses CC; no

7

Glialoma treatment options

1. Whole brain radiation; 2. Resection (if low grade)

8

Risk of radiation therapy?

Radionecrosis of brain tissue

9

Oligodendendroglioma patient population and presentation

Middle age, F>M, frontal lobe, fried egg appearance; 5 year survival

10

Ependymoma patient population and thing to remember

Children/young adults, posterior fossa/spinal cord, rosettes, can cause hydrocephalus; OFTEN SEED

11

Choroid plexus tumors are common/rare and cause, patient population. Most common ventricle? Presentation?

Rare; over secretion of CSF (hydrocephalus), children; fourth ventricle; increased ICP (VI nerve palsy = diplopia)

12

Meningiomas are most common in women/men; young/old; benign/malignant; histology?

Women, older (>40), benign; psamommma bodies

13

What can induce a meningioma?

Radiation therapy

14

Treatment (2); probably won't use...

Nothing if they're small or surgical removal (not always easy); radiation/chemotherapy

15

Olfactory groove meningioma can lead to...presents as?

Dementia; anosmia

16

Other places for meningiomas

F

17

Common schwannoma, prsentation, treatment

Acoustic neuroma; tinnitus/deafness/compression of other CNs (VII); surgery

18

Common pituitary tumors (2)

Pituitary adenomas, craniopharyngiomas

19

Pituitary tumor types (2)

Micro and macroadenomas (are large and can compress structures)

20

Pituitary tumors can do what...two most common?

Secretion of hormones; prolactinoma, then GH

21

If your growth plates have NOT closed and you get a GH secreting pituitary tumor, you get...

Giantism

22

Craniopharyngiomas often contain, patient population, and associated problems

Calcium; young children; hypothalamic and visual problems, hydrocephalus (3rd ventricle problems)

23

Pinealomas hint

Elevated HCG or alpha fetoprotein

24

% Brain tumors due to metastasis

50%

25

Medulloblastoma patient population and region it affects? Presents as? Are these malignant?

Second most common pediatric BT after glioma; cerebellum; acute obstructive hydrocephalus; YES, they seed

26

Hemangioblastoma are often where and can secerete what?

Cerebellum; erthropoietin

27

Describe primary cerebral lymphoma: patient population and outcome

Immunosuppressed; cognitive impairment due to RT, poor outcome

28

How often do people with systemic cancer get brain metastasis? (%)

20-30%

29

Subfalcine herniation (def) and presentation

Herniation under falx: headache, contralateral leg weakness (not very serious)

30

Uncal herniation puts pressure on _________, producing ____________ (ipsi or contralateral? What's the final symptom (ipsi or contralateral)? Will a patient be awake? Why?

Midbrain; contralateral hemiparesis; ipsilateral IIIrd nerve palsy; no, loss of consciousness due to distortion of ARAS in midbrain

31

What is a strange consequence of an uncal herniation? This is what kind of sign?

Kernohan notch: herniation pushes against OPPOSITE edge of tentorium ipsilateral paresis; "false localization" sign

32

Central herniation causes what kind of deterioration...

Rostro-caudal deterioration (one brainstem syndrome after another)

33

Cerebellar tonsils can herniate into...bad when?

Foramen magnum; Coma and death result when these herniations compress the brain stem.

34

So...four herniation syndromes?

Subfalcine, central, uncal, cerebellar tonsillar

35

How do we treat herniation?

First: remove lesion then treat cerebral edema

36

Types of cerebral edema

Vasogenic, cytotoxic, interstitial, osmotic

37

Vasogenic edema; treatment?

Breakdown of BBB; steroids

38

Cytotoxic edema

BBB intact, problem in cellular functioning

39

Wilderness medicine! Important cytotoxic edema point

Altitude can cause cytotoxic edema

40

Interstitial edema seen in? Treatment:

Seen in obstructive HC; SHUNT

41

Osmotic edema; associated with...

Impairment of osmolality of blood; water intoxication and dialysis

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