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71 Cards in this Set

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  • Back
How is the pediatric population divided with regard to brain tumor?
Neonates and infants (under 2 years)


Older children
How common are brain tumors in the under 2 yrs group?
Uncommon
How common are they in the older (>2) group?
Second only to hematopoietic tumors with regard to neoplasms
What proportion of brain tumors are supratentorial in neonatal/infant group?
2/3
What is the most common brain tumor in the neonatal period?
Teratoma
What are the common tumors in in the under 2 group?
PNET


Teratoma


Astrocytoma


Choroid plexus papilloma
What are the common types of astrocytoma in the under 2 group?
Very aggressive types: Anaplastic or GBM
What proportion of brain tumors are supratentorial in the older group?
1/2
What are the common neoplasms in this group?
Gliomas

PNET

Ependymoma

Craniopharyngioma

Pineal region tumors
What percent of tumors are gliomas in this group.
50%
What percent are PNETs?
15%

Medulloblastoma is just a subset of these
What percent are ependymoma?
10%
What percent are craniopharyngioma?
10%
What percent are pineal region?
3%
What is true of gliomas in this group?
Most are astrocytomas
What percent of supratentorial neoplasms in this group are astrocytomas?
50%
What is true of astrocytomas in this group?
Most are low grade:

Pilocytic or other low grade
What are other gliomas in this age group?
Oligodendroglioma


Ganglioglioma
What tumors occur in the infratentorial region?
Cerebellar astrocytoma


PNET


Brainstem glioma


Ependymoma
What percent of infratentorial neoplasms are cerebellar astrocytoma?
35%
What percent are PNET?
30%
What are these PNETs?
Medulloblastoma
What percent are brainstem glioma?
25%
What percent are ependymoma?
10%
What is true of most cerebellar astrocytomas?
Pilocytic
What is true of pontine brainstem gliomas?
All are malignant
What is true of medullary gliomas?
More benign
What is special about medulloblastomas?
Most arise in the vermis
What percent arise in vermis?
90%
Where do the rest occur?
Most of rest in cerebellar hemispheres
What is the most common adult primary brain tumor?
Glioma
What percent are gliomas?
50%
What are most gliomas?
astrocytomas
What percent of gliomas are astrocytomas?
70%
What are the most common astrocytoma types in adults?
More than 50% of all astrocytomas are Anaplastic or GBM.
What is the second most common primary brain tumor?
Meningioma
What percent of all brain tumors in adults are meningiomas?
20%
What percent of all brain tumors are sellar/parasellar?
8%
What is the most common of these?
Pituitary adenoma
What is the next most common glioma after astrocytoma?
oligodendroglioma
What percent of all primary brain tumors is this?
5%
What is the most rising incidence primary brain tumor?
Lymphoma
What do the most common infratentorial neoplasms in adults have in common?
All are extraaxial
What are these?
Schwannoma


Meningioma


Epidermoid
What is the most common intraaxial infratentorial brain tumor?
Mets
What are the most common primary intraaxial posterior fossa tumors?
Hemangioblastoma


Brainstem glioma
What is the most important factor in arriving at a differential diagnosis of a brain mass?
Location
What is the second most common factor?
Patient age
What are the main criteria for location?
Intraaxial or extraaxial


Supratentorial or infratentorial
Besides basic parenchymal lesions, what are the specific lesion locations which can provide for a differential diagnosis?

First?
Sellar/Suprasellar
2?
Intraventricular
3?
Pineal
4?
Cerebellopontine angle
5?
Foramen magnum
6?
Skull base and cavernous sinus
7?
Scalp, calvarium, meninges
What is the location of the pineal gland?
Posterior to the third ventricle
What is inferior to the pineal gland?
Posterior commisure of corpus callosum
What else is inferior to the pineal?
cerebral aqueduct
What else is inferior to the pineal?
Tectal plate
What are the structures of the pineal region?
Pineal gland



Posterior aspect of third ventricle and cerebral aqueduct



Cisterns



Brain



Dura



Vessels
What cisterns are in the pineal region?
Quadrigeminal plate


Ambient
What other structure, which may be recognizable on imaging, is also a cistern like structure in the pineal region?
Velum interpositum
What portions of brain are in the pineal region?
Tectum


Thalami


Corpus callosum
Specifically, what part of corpus callosum is in pineal region?
Splenium
What anatomic dural structure is in the pineal region?
Tentorial apex
What veins are in the pineal region?
Internal cerebral veins


Vein of Galen
What arteries are in the pineal region?
Posterior cerebral artery


Posterior choroidal artery
What portion of the third ventricle is in closest approximation to the pineal gland?
Suprapineal recess of third ventricle
Where does the suprapineal recess go?
Extends posteriorly, immediately above the pineal gland
Where is the quadrigeminal plate cistern in relation to the pineal gland?
Posterior to it