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Clerkship - Neuro - Brain tumors (blueprints)


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the most common metastatic brain tumor is from the _____?
common brain tumor metastases: (4)
lung, breast
Risk factor for primary brain tumors:
ionizing radiation
Generalized signs of brain tumors are usually due to:

and present as:
increased intracranial pressure (ICP)

HEADACHE, papilledema, nausea, vomiting, SEIZURES
Test of choice for diagnosis of brain tumor:
contrast-enhanced MRI scan

you can also use CT - shows ring-enhancing lesion (but ring enhancing lesion is also seen in abscesses...)
2 major categories of Glial tumors:

most common malignant brain tumor of childhood?
where does medulloblastoma arise from?
medulloblastoma arises from cerebellum --> obstruction of flow of CSF in the aquaduct of the brainstem --> increased ICP

midline of cerebellum also --> truncal ataxia, unsteadiness of gait
does medullobastoma metastasize?
yes. to other parts of the brain and spinal cord, and outside CNS

Therefore contrast-enhancing imaging of the entire brain and spinal cord is indicated
Most common BENIGN brain tumor:?
treatment for meningioma?
surgical for symptomatic lesions and observation for small asymptomatic lesions
What type of cancer is Primary CNS lymphoma (PCNSL)?
PCNSL is a diffuse non-Hodgkins lymphoma. Almost always B-cell derived.

Increasing, especially in AIDS patients
Common presentation in PCNSL
cognitive and behavioral changes - lesions are usually multifocal
PCNSL can spread where?
PCNSL can spread to CSF, eye, and bone
Tx for PCNSL
Tx for PCNSL is chemo with or without radiation
If you see bilateral acoustic neuroma think:
neurofibromatosis type 2
what is an acoustic neuroma?
a benign tumor (schwannoma) of the 8th cranial nerve
acoustic neuroma typically presents with?
unilateral hearing loss - except if it's a bilateral neuroma (seen in neurofibromatosis 2)
most common symptoms of pituitary ademona

bitemporal hemianopia

possibly -->
decreased growth hormone and gonadotropin
increased prolactin --> galactorrhea, growth hormone excess --> acromegaly, gigantism,
excess corticotropin --> Chushing's disease.

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