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27 Cards in this Set

  • Front
  • Back
How much is known about the pathogenesis of CNS tumors?
Very little
What are 4 factors that may contribute to nervous system tumor formation?
-Genetic disposition
-Hamartomatous/vestigial tissues
-Viral infections
-Carcinogenic chemicals
What are 3 hereditary familial diseases associated with nervous system tumors?
-von Recklinghausen's
-von Hipple-Lindau's disease
-Tuberous sclerosis
What 3 tumors are associated with von Recklinghausen's neurofibromatosis?
-Neurofibroma
-Glioma
-Meningioma
What tumor is associated with von Hipple-Lindau's disease?
Hemangioblastoma
What tumor is associated with Tuberous sclerosis?
Subependymal giant cell astrocytoma
What are 2 other tumors that are often familial?
-Retinoblastoma
-Medulloblastoma
What chromosomal abnormalities are associated with neuroblastomas?
-Ch 1
-Ch 17
Whatever the actual cause, what is presently considered to be responsible for initiating tumor formation in the nervous system?
Activation of oncogenes
What are 2 broad categories of effects of brain tumors?
-Local effects
-General effects (complications)
What are the local effects of brain tumors caused by?
Destruction of brain tissue by the tumor
What are general effects of tumors caused by?
The fact that these are space-occupying lesions.
How do general effects of tumors compare to local effects?
They are more serious, self-perpetuating, and will lead to death if unrelieved.
What are 4 general effects or complications of cns tumors?
-Brain edema
-Hydrocephalus
-Internal herniation w/ secondary vascular effects
-Pressure effects on the skull and spinal cord
Why do tumors in the brain cause edema?
Because of vascular injury and resulting increased capillary permeability
So what is the more prominent form of edema seen caused by brain tumors?
Vasogenic > cytotoxic
Where is the main site of edema due to tumors?
White matter
What are 2 mechanisms of hydrocephalus caused by tumors?
-Obstruction of foramen of monro
or aqueduct by the tumor
-Decreased CSF absorption due to generalized tumor infiltration of the meninges
What are 4 types of internal herniations that can occur due to nervous system tumors?
-Cingulate (subfalcine)
-Uncal
-Hippocampal
-Tonsillar
What can cause such internal herniation?
-The tumor itself
-Pressure from hydrocephalus or brain edema
When will external herniation of the brain outside the skull only be seen?
If the dura and skull have been partially removed by surgery
What effects can increased ICP have on the sella turcica?
-Flattening of the dorsum
-Flattening of posterior clinoid processes
What is the most common and serious consequence of an intraspinal, extramedullary neoplasm?
Spinal cord compression
What does tumor compression of the blood vessels by an extramedullary intraspinal neoplasm result in?
Compression necrosis and ischemic infarction.
What is a more important determinant of clinical severity of a brain tumor (even benign) than for other organ tumors?
Location
What can make a benign tumor clinically malignant?
Being located in a vital area like the brainstem.
Do primary brain tumors metastesize very often?
no