CNS tumours

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CNS tumours
2010-11-07 03:59:20
CNS tumours

CNS tumours
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  1. Name the 3 groups of clinical features in CNS tumours.
    • Raised ICP: bradycardia, headache/vomitting, papilloedema (late)
    • Localising signs: aphasia, hemiparesis, visual field defects, other focal neurological signs
    • Non-localising signs: Seizures/ altered mental state
  2. What are the 3 Ix used for CNS tumours?
    • MRI: most sensitive, hypointense on T1 and hyperintense on T2
    • CT: most sensitive for detecting focal calcifications
    • Stereotactic biopsy: for confirmation of diagnosis before treatment
  3. Name 5 types of CNS tumours.
    • Glioma: astrocytic glioma, oligodendroglioma, ependymoma (not truly a glioma)
    • Meningioma: F>M, near tentorial cerebelli and falx cerebri
    • Schwannoma: commonly from eighth nerve
    • Medulloblastoma: young children, rapid growth
    • Lymphoma: mostly NON-hodgkin's
    • Pituitary neoplasms
  4. What are the primary cancers that may cause brain mets?
    • Most common: breast, lung
    • Cancers with predilection: melanoma, testicular ca, RCC, thyroid ca
  5. What are some DDx for an old man with memory loss / apathetism over 3/12?
    • Frontal lobe tumour
    • Meningitis
    • Prion disease e.g. Creutzfeldt-Jakob disease (CJD)
    • Cerebral vasculitis
    • MS - unlikely in his age
    • Neurodegenerative disorders
    • Hypothyroidism
  6. What are the DDx for multiple haemorrhagic lesions at the grey-white junction on a brain MRI?
    • Mets - lung, melanoma, breast, RCC
    • Haemorrhagic embolic infarcts
    • Haem disorders with coagulopathy
    • Cerebral vasculitis
    • Infections by vasoinvasive organisms e.g. Aspergillus
  7. What are the DDx for a ring-enhancing lesion on brain MRI?
    • Metastatic tumour
    • Brain abscess
    • Toxoplasmosis
    • Tuberculosis
    • Lymphoma