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CM Brain Tumor
Neurology CM Brain Tumor
| Question | Answer |
|---|---|
| Location of brain tumors in children | most primary brain tumors are located in the posterior fossa. |
| Most common location of brain tumors in adults | most primary brain tumors are located in the cerebral hemispheres. |
| Primary tumors develop from what type of cells? | Non-neuronal. Gliomas or nongliomas |
| 25% of all gliomas are | astrocytomas |
| glioma | come back to |
| glioma come back to | bom |
| 50% of all gliomas are | Grade IV astrocytoma/glioblastoma multiforme. Highly invasive, rapidly growing. Bilateral in 50% of pts. Frequently causes intracerebral hemorrhage. |
| Glioblastoma multiforme can spread to the CSF and cause | meningeal carcinoma. Less than 20% of patients survive one year |
| This type of glioma frequently have calcium deposits on CT. First sx is usually seizure (70%) | Oligodendroglioma. Mean survival is 5 years. |
| This type of glioma is more common in children than adults | Glioma: ependymoma |
| Most common location of Ependymomas | the fourth ventricle causing increased ICP. Arise from cells lining the ventricles |
| medulloblastoma | come ack to |
| Meningiomas are located | in multiple locations throughout the skull. Slow growing. Treatment is usually surgical resection. W>M. peak incidence in the 60's |
| ________ non-gliomas tend to occur in elderly and immunosuppressed people. | CNS Lymphoma. |
| Tx of CNS lymphomas | radiation and steroids |
| What type of imaging best reveals CNS lymphomas? | CT Scan with contrast |
| Most common type of tumor | Adenoma. Most common type of hormone produced: prolactin. |
| How does prolactin affect women? | Amenorrhea and + galactorrhea. |
| How does dopamine affect prolactin? | Dopamine inhibits prolactin. So, in pituitary adenomas where prolactin is secreted, dopamine agonists can be used. |
| This tumor typically occurs at the vestibular portion of the eighth cranial nerve | Non-gliomas: acoustic neuroma. Early sx: loss of hearing in the affected ear. Tx: surgical |
| Tumors that rarely metastasize to the brain: | prostate, oro-pharyngeal carcinoma and skin cancers other than melanoma |
| Tumors that spread to the brain in order of frequency | lung, breast, melanoma, Gastrointestinal (especially colon and rectum), testicular cancer |
| Brain tumor presentation | Localizing neurologic signs, slow mentation, HA at night and at first awakening, Projectile Vomiting, Seizures, incontinence |
| PE of ICP | Mental slowness, papilledema |
| Causes of ICP | tumor mass, obstruction of CSF outflow, tumor-related edema |
| Treatment of ICP | Steroids are the mainstay, Osmotic agents (mannitol), Hyperventilation (lowers pCO2 causing vasoconstriction). (the last two are short-term temporizing measures) |
| How does mannitol work? | It is hyperosmotic and draws water out. It is only temporizing to be done acutely, b/c eventually it actually adds water |
| Other causes of ICP | pseudotumor cerebri (obese, women), hypertensive encephalopathy (HA, Papilledema, pregnant), and chronic meningitis. |
| Most common cancers that cause paraneoplastic syndrome | small cell lung; ovarian |
| Paraneoplastic syndromes | Eaton lambert, subacute cerebellar degeneration: anti-yo, Brainstem encephalitis + other sx: anti-hu, Sensory peripheral Neuropathy. |
Created by:
ltm12