Flashcards in Week 4 part 2 Deck (60):
What is the commonest extra-axial tumour?
What presents with progressive neurological deficit, motor weakness, headache and seizures?
What is a headache due to if its worse in the morning, wakes them up, increases with coughing/leaning forward and decreased with vomiting?
What can be secondary to diplopia (CN VI) and secondary to difficulty focusing?
A tumour where affects perserveration?
A tumour where affects dyspraxia and neglect?
How do you investigate bran tumour?
CT, MRI LP
What two cells make up neuroepithelial tissue?
What do glial tumours arise from?
Astrocytes or oligodendrocytes
What grade of astrocytoma is truly benign, slow growing, children young adults, pilocytic astrocytomas and treatment of choice is surgery?
grade 1 astrocytomas
What do low grade astrocytomas present with?
Where do low grade astrocytomas want to occur?
IN temporal lobe
What grades are malignant astrocytomas?
Grades III - IV
How common is glioblastoma multiforme (malignant)?
Most common primary tumour - spreads white matter tracking
Tumours are solid, appear grey/whiteish and subarachnoid accumulations are grossly characterised by surgeons as having toothpaste morphology
How do you treat oligodendroglial tumours?
Chemosensitive - procarbazinr, lomustine, vincristine
Arachnoid cap cells, extraaxial, 20% of intracranial neoplasms, majority asymptomatic ?
What condition has vestibular schwannomas?
NF type II
hEARING Loss, tinnitus, dysequilibrium?
What are the red flag s for headaches?
1. New onset over 55 years
2. Known/previous malignancy
4. Early morning headache
5. Exacerbation by valsalva
In the pathophysiology of a migraine what chemical irritates nerves and blood vessels causing pain?
What do the dorsal raphe nucleus and the locus coeruleus make up?
What is more common - migraine with or without aura?
Without (flashibg kights, weakness, balance problems)
What abortive drugs can you give for migraines +/- an anti-emetic?
When should you give triptans fot a migraine?
At start of headaceh
What kind of relief does frovatriptan give for migraines>
When might you consider prophylactic migraine treatment?
If nmroe thanb three attacks per month or very severe consider prophylaxis
When beta blockers are given for migraines qwhat do you need to be careful for?
Avoid asthma, PVD (heart gfaiure)
A carbonic anhydrase inhibityor topiramate can be used for migraine - give some adverse effects?
1. Weight loss
3. Imparied concentration
4. Enzyme inducer
Amitriptyline can be given for migraines - give some adverse effects?
1. Dry mouth
2. Postural hypotension
What are the trigeminal autonomic cephalgias (TACs)?
A group of primary heache disorders characterised by unilateral trigeminakl distribution pain that occurs in association with prominent ipsilateral cranial autonomic features
What are ptosis, miosis, nasal stuffiness, nausea, teareing and eye lid oedema?
Ipsilateral cranial autonomic features
What are cluster, paroxysmal hemicrania, hemicrania continua and SUNCT?
TCA types - trigeminal autonomic cephalgias
What kind of age group get cluster headaches?
30s and 40s
When do people get cluster headaches?
Striking circadian (around sleep) nd seasonal variation
Severe unilateral headache, duration 45-90 minutes, 1 to 8 a day and cluster bout may last from a few weeks to months?
How is cluster headache treated?
1. High flow oxygen
2. Sub cut sumatriptan
4. Verapamil for prohpylaxis
Who gets paroxysmal hemicrania?
Elderly 50s and 60s, women more than men
Severe unilateral headache, unilateral autonomic features, 10-30 minutes, 1 to 40 a day?
Paroxysmal hemicrania (shorter duration and more frequent than cluster)
How is paroxysmal hemicrania treated?
Absolute response to indomethicin
What is short lived, unilateral, neuralgiaform headache, conjunctival injetions and tearing?
How is SUNCT treated?
What is done for patients with new onset unilateral cranial autonomic features?
MRI brain and MR angiogram
Who gets trigeminal neuralgia?
Elderly ikder than 60, women more than men
What headache s triggered by touch, usuall V2/3?
Severe stabbing unilateral pain, 1 second to 90 seconds, 10 to 100 a day, bouts of pain may last from few weeks to months before remission?
If a patinet has trigeminal neuralgia and signs of atypical features, poor response to treatment what might yoyu do?
How is trigeminal neuralgia trated?
Name a trigger for cluster headache?
Alcohol (more common in males)
Are the majority of adult brain tumours supratentorial or infratentorial?
Supratentorial - children infratentorial
What brain tumour: pleomorphic tumour cells border necrotic areas?
Gliolastoma multiforme - most common primary brain tumour
What brain tumour: spindle cells in concentric whorls and calcified psammoma bodies?
What schwannoma is seen in cerebellopontine angle?
What is the most common primary brain tumour in children?
What brain tumour: rosenthal fibres (corkscrew eosinophilic bundle)?
What brain tumour: benign, slow growing common in frontal lobes, calcifications with fried egg appearance?
What are these all patterns of: amyotrophic lateral sclerosis, progressive muscular atrophy and bulbar palsy?
wHAT IS associated with low levels of orexin (hypocretin), a protein responsivle for appetite and sleep patterns?
Typical onset teenage years, hypersomnolence, cataplexy (sudden loss of muscle tone triggered by emotion), sleep paralysis and vivid hallucinations on going to sleep or waking up?