T Flashcards
(37 cards)
May have characteristics of both glia and epithelium
Ependymomas
Ectodermal structures related to the brain
Meningioma
Lymphocytic brain tumor
CNS Lymphoma
Precursor neuronal elements
Neuroblastoma, medulloblastoma
Germ cells
germinoma, craniopharyngioma,
teratoma
Endocrine elements brain tumor
pituitary adenoma
Type of glioma with poor prognosis
Glioblastoma multiforme
T or F. Most classifications have been based on the
presumed cell of origin of the neoplasm, while
grading systems are meant to be an estimate of the
rate of growth and clinical behavior
True
Which of the ff id correctly match among the
ASTROCYTIC TUMORS
A. Noninvasive: Pilocytic and subependymal giant cell astrocytomas
and pleomorphic xanthoastrocytoma (grade II)
B. Diffuse astrocytoma (grade V)
C. Anaplastic astrocytoma (grade III)
D. Glioblastoma multiforme (grade (I)
B. Diffuse astrocytoma (grade II)
Which is correctly match among the
OLIGODENDROGLIAL TUMORS
A. Oligodendroglioma (grade I)
B. Anaplastic (malignant) oligodendroglioma (grade III)
B. Anaplastic (malignant) oligodendroglioma (grade III)
III. EPENDYMAL CELL TUMORS
A. Ependymoma (grade II)
B. Anaplastic ependymoma (grade III)
C. Myxopapillary ependymoma
D. Subependymoma (grade I)
E. All of the above
E. All of the above
T or F. According to the Monro-Kellie doctrine, the total
bulk of the three elements is always constant, and
any increase in the volume of one of them must be
at the expense of the others
True
Cranial cavity has a restricted volume, and the
three elements contained therein
• the brain (about 1,200 to 1,400 mL)
• cerebrospinal fluid (CSF; 70 to 140 mL)
• blood (150 mL)
T or F
Once pressure is raised in a particular
compartment of the cranium, the tumor begins
to displace tissue at first locally and at a
distance from the tumor, resulting in a number
of false localizing signs, including coma
True
T or F
With tumor growth, the venules in the cerebral
tissue adjacent to the tumor are compressed, with
resulting elevation of capillary pressure, particularly
in the cerebral white matter where edema is most
prominent.
True
A type of brain edema in the extracellular edema due to increased permeability of brain capillaries (BBB breakdown). It is mainly in the white matter
This is an opening of the junction allowing fluid to escape causing edema in the periphery.
Usually seen in tumors d/t poor outflow of the venous drainage.
Vasogenic brain edema
A type of intracellular edema due to an osmotic imbalance between the cell and the extracellular fluid, mainly in the gray matter.
Usually seen in stroke, infarct.
There’s damage of the cell that will lead to swelling in the capillaries leading to edema of the capillaries, then swelling happens in the periphery.
Cytotoxic (cellular) brain edema
A type of extracellular edema in periventricular white matter due to the transependymal flow of CSF in hydrocephalus
Hyperdense areas on CT
Interstitial (hydrocephalic) brain edema
What is the treatment of Brain Edema and
Raised ICP
high-potency glucocorticosteroids
The use of high-potency glucocorticosteroids has a
beneficial effect on the vasogenic edema associated
with tumors, both primary and metastatic
Medication that shrinks normal brain tissue, thus reducing
overall intracranial pressure
Steroids
Another treatment for Brain Edema and
Raised ICP
Dexamethasone 5-10mg IV q6-8 hours and tapered off
gradually over a span of 3-4 weeks
What solution must always be used in patients who have brain edema and who
require intravenous fluids
always use solutions with normal osmolarity. (plain NSS)
Avoid solutions containing water (“free
water”) and dextrose solutions alone, in any
concentration (hypo-osmolar solutions)
It is the most widely used osmotic
agent
Mannitol
20 percent solution is administered
parenterally in a dose of 0.5 to 2.0 g/kg body
weight over a period of 2 to 10 min.
Hypertonic saline solutions (3, 7, or 23
percent) are equally effective
0.5-.75 mg/kg q6
May be helpful in
special instances (interstitial edema,
pseudotumor cerebri) by virtue of
creating a hyperosmolar state and by
reducing the formation of CSF
Diuretic drugs
acetazolamide reduces CSF production, increase risk for respiratory acidosis or alkalosis
and furosemide
For emergency cases
is another
method of rapidly reducing brain volume producing respiratory alkalosis and cerebral
vasoconstriction
The patient should be intubated, decreased sensorium
Either increase the O2 saturation and RR rate to 22-26 BPM
The goal is to blow off carbon to produce respiratory alkalosis which includes vasoconstriction.
Controlled hyperventilation
