Brain Tumors: Types and Definitions

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to Lesson

Podcast

Play an AI-generated podcast conversation about this lesson
Download our mobile app to listen on the go
Get App

Questions and Answers

Which of the following mechanisms directly contributes to the development of headaches in patients with brain tumors?

  • Increased intracranial tension causing abnormal stretching of meninges and intracranial vessels. (correct)
  • Tumor-induced release of endogenous opioids desensitizing central pain pathways.
  • Direct infiltration of nociceptors within the brain parenchyma by tumor cells.
  • Metabolic waste accumulation stimulating pain receptors in the cerebral cortex.

In the context of brain tumors, what is the primary reason that vomiting occurs as an early symptom of medulloblastoma?

  • Hormonal imbalances caused by tumor interference with pituitary gland function.
  • Direct compression of the vagus nerve leading to parasympathetic overstimulation.
  • Congestion of the chemotrigger zone in the medulla oblongata. (correct)
  • Release of neurotoxins by tumor cells that directly irritate the gastric mucosa.

Which feature is most indicative of headaches associated with brain tumors, particularly those causing increased intracranial pressure?

  • Exacerbation at night due to CO2 accumulation and venous congestion. (correct)
  • Relief with regular doses of over-the-counter analgesics.
  • Localization strictly to the site of the lesion.
  • Association with specific dietary triggers.

Why does papilledema typically lead to blurring of vision in a patient with a brain tumor?

<p>Venous congestion of the retina and optic disc, leading to oedema of the optic disc. (A)</p> Signup and view all the answers

An elderly patient presents with a solitary cerebellar lesion. What is the MOST likely nature of this lesion?

<p>Metastatic tumor. (A)</p> Signup and view all the answers

Which mechanism explains how vascular tumors specifically contribute to increased intracranial pressure (ICP)?

<p>By increasing cerebral blood flow, leading to increased blood volume within the skull. (B)</p> Signup and view all the answers

Which diagnostic finding on a plain skull X-ray would MOST strongly suggest chronically elevated intracranial pressure (ICP) in a child?

<p>Separation of sutures and a 'silver beaten' appearance. (D)</p> Signup and view all the answers

What is the expected clinical presentation for a patient diagnosed with a brain tumor affecting the prefrontal area of the frontal lobe?

<p>Changes in personality, memory, and cognitive function, leading to deterioration. (D)</p> Signup and view all the answers

A patient exhibits dysphasia and difficulty with both speaking and writing, following the diagnosis of a brain tumor. Where is the MOST likely location of the tumor?

<p>Broca's Area in the dominant hemisphere of the Frontal Lobe. (C)</p> Signup and view all the answers

A farmer is evaluated for new-onset seizures characterized by a sensation of fear, automatism, and lip-smacking, but no loss of consciousness. Considering the focal cranial manifestations of brain tumors, which lobe is MOST likely affected?

<p>Temporal Lobe. (A)</p> Signup and view all the answers

A patient is diagnosed with a lesion in the left occipital lobe that results in vision loss. What specific type of visual field defect is the patient MOST likely to experience, and why?

<p>Right homonymous hemianopia with macular sparing because of collateral blood supply to the macular region. (B)</p> Signup and view all the answers

What clinical findings would MOST strongly suggest a non-secretory pituitary tumor causing chiasmal compression?

<p>Bitemporal hemianopia and hypopituitarism. (B)</p> Signup and view all the answers

A patient presents with headaches, nausea, and progressive blurring of vision. What would be the MOST appropriate initial imaging to determine the presence and characteristics of possible brain tumors?

<p>Magnetic Resonance Imaging (MRI) with contrast. (B)</p> Signup and view all the answers

What distinguishes a 'false localizing sign' from a true localizing sign in cases of increased intracranial pressure (ICP) due to a brain tumor?

<p>False localizing signs indicate dysfunction distant from the primary lesion due to the widespread effects of increased ICP. (C)</p> Signup and view all the answers

Which type of brain tumor is MOST likely to directly arise from the meninges?

<p>Meningioma. (A)</p> Signup and view all the answers

Which type of brain lesion is characterized as a non-neoplastic space-occupying lesion?

<p>Tuberculoma. (D)</p> Signup and view all the answers

Which neurological deficit is MOST closely associated with tumors affecting the brainstem?

<p>Cranial nerve deficits and long tract signs. (B)</p> Signup and view all the answers

How can a choroid plexus papilloma lead to increased intracranial pressure (ICP)?

<p>By increasing the production of cerebrospinal fluid (CSF). (A)</p> Signup and view all the answers

When managing a patient with a brain tumor, which treatment would directly address cerebral edema?

<p>Dehydrating measures that include steroids and diuretics. (B)</p> Signup and view all the answers

Which of the following is the MOST likely origin of a brain tumor presenting as acoustic neuroma?

<p>Cranial Nerves (neuroma &quot;Schwannoma&quot;). (B)</p> Signup and view all the answers

A patient presents with bitemporal hemianopia. Which primary brain tumor location should be MOST suspected based on this visual field defect?

<p>Pituitary gland. (A)</p> Signup and view all the answers

A patient presents with progressive personality changes, cognitive decline, and urinary incontinence. Which type of brain tumor and location is MOST consistent with these findings?

<p>Astrocytoma in the frontal lobe. (C)</p> Signup and view all the answers

What is the significance of identifying metastasis when diagnosing brain tumors?

<p>If found in old age, it is most likely a solitary cerebellar lesion. (C)</p> Signup and view all the answers

A 60-year-old patient with a history of lung cancer presents with new-onset seizures, headache, and right-sided weakness. Imaging reveals multiple lesions throughout the brain. What is the MOST likely diagnosis considering these findings?

<p>Metastatic brain tumors. (B)</p> Signup and view all the answers

A patient presents with gait instability, clumsiness, and difficulty with fine motor tasks. Which area of the brain is MOST likely affected by a tumor?

<p>Cerebellum. (C)</p> Signup and view all the answers

What feature differentiates headache caused by increased intracranial pressure (ICP) from other types of headache?

<p>Headache that worsens at night due to CO2 accumulation and venous congestion. (B)</p> Signup and view all the answers

Which symptom is LEAST likely to be associated with increased intracranial pressure (ICP)?

<p>Hypotension. (D)</p> Signup and view all the answers

Which of the following is the MOST likely origin of brain tumors presenting as osteoma and osteosarcoma?

<p>Bone. (A)</p> Signup and view all the answers

Which initial symptom is most concerning with pituitary adenoma?

<p>Chiasmal deterioration. (C)</p> Signup and view all the answers

What is the treatment for cerebral edema?

<p>Steroids and Lasix. (A)</p> Signup and view all the answers

Increase in ICP (intracranial tension) can cause headaches due to...

<p>Stretch of dura mater. (A)</p> Signup and view all the answers

If there is a destructive lesion to the parietal lobe what symptom would the patient have?

<p>Cortical sensory loss of the opposite side of the body. (D)</p> Signup and view all the answers

What is the most common site for partial epilepsy?

<p>Temporal Lobe. (B)</p> Signup and view all the answers

If a patient is suspected of having a brain related issue what would be the first choice procedure to use?

<p>MRI with contrast. (B)</p> Signup and view all the answers

Which site of tumors with metastasis in the brain is least common?

<p>Heart. (C)</p> Signup and view all the answers

What is the most likely treatment for a patient with increased ICP and a brain tumor?

<p>Lasix and Mannitol. (B)</p> Signup and view all the answers

In the context of brain tumors, what is the rationale behind using steroids and diuretics as dehydrating measures in medical management?

<p>To reduce cerebral edema and intracranial pressure by promoting fluid excretion and reducing inflammation. (A)</p> Signup and view all the answers

A patient presents with gait ataxia, and upon neurological examination, exhibits signs of truncal instability and limb incoordination. Considering the focal cranial manifestations of brain tumors, which area is MOST likely affected?

<p>Cerebellum (C)</p> Signup and view all the answers

A patient with a known primary tumor in the gastrointestinal tract (GIT) presents with new neurological symptoms including headache, seizures, and focal weakness. What is the MOST critical implication of these findings in the context of brain tumors?

<p>The patient should be evaluated for potential brain metastases, as GIT cancers commonly metastasize to the brain. (D)</p> Signup and view all the answers

Following a detailed neurological examination, a patient is diagnosed with VI nerve palsy as a result of increased intracranial pressure (ICP) due to a brain tumor. Why is VI nerve palsy considered a 'false localizing sign' in such cases?

<p>Increased ICP affects the VI nerve due to its long intracranial course and vulnerability, not necessarily indicating the tumor's precise location. (B)</p> Signup and view all the answers

A patient experiences severe headaches that are most intense during the night. Considering the pathophysiology of headaches related to brain tumors, what mechanism primarily explains the nocturnal exacerbation of the patient's headaches?

<p>The effects of gravity while lying down increase intracranial pressure due to venous congestion and increased CO2 (B)</p> Signup and view all the answers

Flashcards

Brain Tumor Definition

Lesions occupying space within the cranial cavity, leading to increased intracranial pressure and/or focal cranial signs.

Bone Primary Tumors

Arise from bone; examples include osteoma and osteosarcoma.

Meningeal Primary Tumors

Arise from meninges; examples include meningioma and meningiosarcoma.

Brain Tissue Primary Tumors

Arise from brain tissues; includes gliomas, astrocytomas (G 1-4), and glioblastoma multiforme.

Signup and view all the flashcards

Embryonic Remnant Tumors

Arise from embryonic remnants; examples include craniopharyngioma, chordoma, and medulloblastoma.

Signup and view all the flashcards

Cranial Nerve Tumors

Examples include neuroma (Schwannoma) of the acoustic or trigeminal nerves.

Signup and view all the flashcards

Secondary Brain Tumors

Originates from primary tumors located elsewhere in the body, spreading to the brain.

Signup and view all the flashcards

How Brain Tumors Cause Headache

Brain tumors may cause headache through increased intracranial tension, pressure on sensory areas, or erosion of skull bones.

Signup and view all the flashcards

Characteristics of Headache

Usually severe, throbbing, and can be frontal, temporal, or generalized; unrelated to lesion site except in specific cases.

Signup and view all the flashcards

Headache Worse at Night

Can be due to CO2 accumulation during sleep and venous congestion during recumbency.

Signup and view all the flashcards

Factors Affecting Headache

This is worsened by straining and partly relieved by analgesics or diuretics.

Signup and view all the flashcards

Brain tumors (definition)

Space occupying lesions (SOLs) within the cranial cavity.

Signup and view all the flashcards

Neoplastic brain tumors

Primary brain tumours and Secondary (metastatic) brain tumours.

Signup and view all the flashcards

Manifestations

Increased intracranial pressure (ICP).

Signup and view all the flashcards

Increased ICP Symptoms

Headache, Nausea/Vomiting, Blurring of Vision, Hypertension, Bradycardia.

Signup and view all the flashcards

VI Nerve Palsy

A common false localizing sign due to increased ICP.

Signup and view all the flashcards

brain tumor manifestations

The localizing manifestations differ according to the site of brain tumor.

Signup and view all the flashcards

Brain tumor investigations

Plain x-ray, MRI brain and Cerebral angiography

Signup and view all the flashcards

Management of brain tumors

Medical and surgical management.

Signup and view all the flashcards

Headache Characteristic

Severe headache.

Signup and view all the flashcards

Worse at night

Co2 accumulation due to slow respiration during sleep and venous congestion during recumbency.

Signup and view all the flashcards

Vomiting

It usually occurs at peak of headache

Signup and view all the flashcards

Pathogenesis of Vomiting

Congestion of chemotrigger zone in medulla oblongata

Signup and view all the flashcards

Blurring of vision

Due to papilleodema (oedema of optic disc) due to venous congestion of retina and optic disc.

Signup and view all the flashcards

HOW BRAIN TUMORS INCREASE ICP?

They are mass lesions & obstruction of CSF pathway → hydrocephalus

Signup and view all the flashcards

Prefrontal Area of Frontal Lobe

Mental, memory, cognitive, personality and behavior changes.

Signup and view all the flashcards

Broca's Area lesion

Dysphasia or aphasia (speech deficit).

Signup and view all the flashcards

Precentral Gyrus Destructive Lesion

Weakness of opposite side (monoparesis or hemiparesis).

Signup and view all the flashcards

Irritative Lesion

Focal motor fits (fits= convulsions= seizures= epilepsy).

Signup and view all the flashcards

Parietal Lobe: (Sensory Area)

Cortical sensory loss of opposite side of the body.

Signup and view all the flashcards

Destructive temporal lobe.

Mild affection of smell, taste, and hearing.

Signup and view all the flashcards

Irritative Temporal Lobe

Fits (temporal lobe fits).

Signup and view all the flashcards

Destructive occipital lesion

Crossed homonomus hemianopia with macular sparing.

Signup and view all the flashcards

Pituitary Gland Tumors

Hormonal syndromes and visual deterioration

Signup and view all the flashcards

Plain X-Ray

separation of sutures and/or silver beaten appearance due to high ICP

Signup and view all the flashcards

MRI Brain

With contrast; procedure of choice for all brain tumors for diagnosis and surgical planning.

Signup and view all the flashcards

Medical

dehydrating measures + Antiepileptic drugs

Signup and view all the flashcards

Brain tumor management

Medical and surgical management.

Signup and view all the flashcards

Presenting Symptoms

Manifestations of increased intracranial tension

Signup and view all the flashcards

Brain tumor presentation 1

Manifestations due to increased intracranial tension.

Signup and view all the flashcards

Brain tumor presentation 2

Focal cranial manifestations according to site of lesion

Signup and view all the flashcards

Brain tumor presentation 3

Both general and focal manifestations

Signup and view all the flashcards

Osteoma

Tumor arising from bone.

Signup and view all the flashcards

Papilledema

Swelling of the optic disc.

Signup and view all the flashcards

Study Notes

Brain Tumors Definition

  • Space-occupying lesions (SOLs) exist within the cranial cavity.
  • SOLs give rise to increased intracranial pressure.
  • SOLs cause focal cranial manifestations depending on lesion site.

Pathological Types of Brain Tumors

  • Neoplastic tumors include primary and secondary (metastatic) brain tumors.
  • Non-Neoplastic tumors include brain abscesses, tuberculomas, and parasitic cysts.

Neoplastic SOL Primary Tumors

  • Primary tumors arise from various structures.
  • Bone tumors can be osteomas or osteosarcomas.
  • Meninges tumors can be meningiomas or meningiosarcomas.
  • Glial cells can be gliomas, astrocytomas (G 1-4), or glioblastoma multiforme.
  • Ependymal cells can form ependymomas.
  • Pituitary gland tumors include adenomas and adenocarcinomas.
  • Embryonic remnants can lead to craniopharyngiomas, chordomas, and medulloblastomas.
  • The pineal gland can develop pinealomas.
  • Cranial nerves can give rise to neuromas like Schwannomas (e.g., acoustic or trigeminal neuroma).
  • The choroid plexus can form choroid plexus papillomas.

Metastatic Tumors

  • Metastatic tumors are not rare, especially in old age.
  • Metastatic tumors are commonly multiple and bilateral.
  • A solitary cerebellar lesion in old age is often metastatic.
  • Common primary tumor sites for brain metastasis include the breast, kidneys, thyroid, GIT, and testis.

Brain Abscess

  • Brain abscesses are non-neoplastic SOLs.

Clinical Picture of Brain Tumors

  • Brain tumors present in three ways: manifestations of increased intracranial tension, focal cranial manifestations, or both.

Manifestations of Increased Intracranial Pressure (ICP)

  • Increased ICP can cause headache, nausea/vomiting, blurring of vision, hypertension, and bradycardia.
  • VI nerve palsy can be a false localizing sign due to increased ICP affecting the long, thin nerve.

Headache

  • Headaches are severe.
  • Headaches can be throbbing, bursting, or dull-aching.
  • Headaches may be frontal, temporal, or generalized.
  • Headache location does not correlate with lesion site, except: bitemporal headaches in pituitary tumors and suboccipital headaches in infratentorial tumors.
  • Headaches worsen at night due to CO2 accumulation and venous congestion during sleep.
  • Straining increases headaches.
  • Analgesics and/or diuretics partly relieve headaches.

Pathogenesis of Headache from Brain Tumors

  • Brain tumors cause headaches through three mechanisms: increased intracranial tension, pressure on sensory areas (e.g., V cranial nerve), and erosion of skull bones.
  • Brain tissue is not sensitive to pain.

Vomiting

  • Vomiting usually occurs at the peak of a headache.
  • Headache is partly relieved by vomiting.
  • Vomiting is not preceded by nausea.
  • Vomiting is unrelated to meals.
  • Vomiting may be projectile (rare).
  • Regular antiemetics do not relieve vomiting.

Pathogenesis of Vomiting

  • Vomiting results from congestion of the chemoreceptor trigger zone in the medulla oblongata.
  • Vomiting is an early symptom in medulloblastoma.

Blurring of Vision

  • Blurring of vision is linked to papilledema (optic disc edema).
  • Papilledema arises from venous congestion of the retina/optic disc.

How Brain Tumors Increase ICP

  • Mass lesions cause increased ICP.
  • Vascular tumors increase cerebral blood flow.
  • Increased CSF production occurs with choroid plexus papillomas.
  • Obstruction of the CSF pathway leads to hydrocephalus.
  • Tumors can cause massive oedema.
  • Hemorrhage inside the tumor will elevate pressures.

Focal Cranial Manifestations of Brain Tumors

  • Localizing manifestations differ based on tumor site.
  • Symptoms are gradual and progressive.

Frontal Lobe Manifestations

  • Prefrontal area damage causes mental, memory, cognitive, personality, and behavior changes (deterioration).
  • Mood changes may occur.
  • Broca's area damage (dominant hemisphere) leads to dysphasia or aphasia (speech, reading, writing deficits).
  • Precentral gyrus (motor area) damage causes: Weakness of the opposite side (monoparesis or hemiparesis) and Irritative lesions causing focal motor fits/seizures/epilepsy

Parietal Lobe Manifestations

  • Destructive lesions result in cortical sensory loss on the opposite side of the body.
  • Irritative lesions can cause focal sensory fits.

Temporal Lobe Manifestations

  • Destructive lesions lead to mild affection of smell, taste, and hearing.
  • Irritative lesions can cause temporal lobe fits.
  • The temporal lobe is the most common site for partial epilepsy.
  • Temporal lobe fits are usually partial, with gastric uprising sensation, fear, automatism, lip smacking, stare, and déjà vu phenomena.
  • Superior quadrantic crossed homonymous hemianopia is a possible symptom.

Occipital Lobe Manifestations

  • Destructive lesions cause crossed homonymous hemianopia with macular sparing.
  • Irritative lesions cause visual hallucinations.

Brain Stem Manifestations

  • Damage affects cranial nerves (LMNL) and long tract manifestations.

Cerebellum Manifestations

  • Truncal ataxia and/or limb ataxia.

Pituitary Gland Tumors

  • These tumors can cause secretory hormonal syndromes.
  • Non-secretory tumors cause chiasmal compression.
  • Chiasmal compression leads to visual deterioration (bitemporal hemianopia), possibly progressing to optic nerve atrophy and blindness.

Investigations for Brain Tumors

  • Plain X-ray: Shows separation of sutures and/or "silver beaten" appearance (due to high ICP) and widening of the Sella turcica.
  • CT scan brain is useful for detecting most lesions and diagnosing hemorrhage inside a tumor.
  • MRI brain (usually with contrast) is the preferred procedure.

Management of Brain Tumors

  • Medical management includes dehydrating measures (steroids, diuretics like Lasix and mannitol) and antiepileptic drugs.
  • Surgical management varies: ranges from biopsy to partial or complete excision, depending on pathology, lesion location, and surgical setup.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Quiz Team

Related Documents

More Like This

Use Quizgecko on...
Open
Browser
Browser