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