Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
34 Cards in this Set
- Front
- Back
|
What symtoms cause a lesion in the cerebellar vermis
|
Truncal ataxia, broad base gait |
|
|
Lesion (tumor) in dominant parietal lobe can cause which syndrome and its S&S. If in non-dominant, which symptom is frecuent |
- Agraphia without alexia (can read but nor write). - Left to right confusion - Digit agnosia - Acalculia. In right side lesions: Neglect |
|
|
Turcot syndrome is associated with which CNS tumors and what typical other tumors |
Turcot S. is form of familial adenomatous polyposis (multiple colon polyps --> Cancer). Mostly with glioblastoma (maybe AA) and medulloblastoma (rarely pineoblastoma). |
|
|
Li Fraumeni Syndrome is associated with which CNS tumors. |
Is a rare syndrome associated with multiple cancers (mutation in the P53 tumor suppresor gene) CNS tumors Astrocytomas, PNET. |
|
|
Low grade gliomas characteristics in MRI and PET
|
T2 - hyperintense Only 30% enhance PET scan - reduced uptake of fluorodeoxyglucose |
|
|
DNT (dysembrioplastic neuroepithelial tumor) characteristics (age, localization, sx, PET)
|
- Bening (WHO G I tumors) Typically in children and young adults. Most common in temporal and frontal lobes Typically ass. with long standing seizures PET scan like other gliomas reduced uptake of fluorodeoxyglucose BUT unlike all other gliomas negative for methionine uptake. Cx usually control seizures chemo or RTX not useful |
|
|
Pleomorphic Xantoastrocytoma characteristics
|
Children and young adults Superficial location > 90% and 50% temporal. MRI: Isodense, solid component that strongly enhances with gadolinium (hypointense cyst component ~ 50-60% large single cyst) |
|
|
What is Lhermitte-Duclos disease |
- AKA: Dysplastic cerebellar gangliocytoma, AKA purkinjoma. Is probably a hamartoma. - WHO G I - Strongly associated with Cowden disease (multiple hamartoma syndrome). |
|
|
Which is the most common primary intraaxial brain tumor |
Astrocytoma -- Glioblastoma most common primary brain tumor |
|
|
What is the ratio for glioblastoma:AA:LGG and their typical age of presentation
|
5 : 3 : 2 and ages: 53 : 41 : 34
|
|
|
Low grade astros 3 cell types of "ordinary astros" which are they and characteristics |
- Fibrillary is most common. - gemistocytic - particularly prone to progress to G III - IV - Protoplasmic |
|
|
> 60% of astros have which mutation, which makes them prone to progress (dediferentiate) |
P53 mutation in chromosome 17p |
|
|
Multiple primary gliomas are associated with which syndromes (~2 -5%) |
Neurofibromatosis and tuberous sclerosis |
|
|
Pylocytic astrocytoma characteristics: Age, location, histology, tx.
|
- One of the most common pediatric brain tumors. Comprise ~ 27-40% of P-fossa tumors. - Age < 20y in 75% of cases - Common locations: cerebellum, optic nerve/chiasma, hypothalamus. 82% periventricular. - Histology typical Rosenthal fibers. - Tx: Surgery, XRT not recomended only if reresection is impossible |
|
|
Optic glioma characteristics
|
- Most LG astros (pylocytic), rarely malignant. - Higher incidence in NF |
|
|
Brainstem glioma characteristics and S&S |
- Usually present with multiple cranial nerve palsies and long tract findings. Hydrocephalus from aqueduct obstruction. |
|
|
Tectal gliomas characteristics, which syndrome develop |
Graly LG astros. Tend to present with hydrocephalus and parinaud syndrome (Supranuclear upward gaze palsy, Lid retraction (Collier's sign) -> setting sun sign, convergence palsy, accomodation palsy. |
|
|
Oligodendroglioma characteristics. Location, sx, histology, frequency, Rx, Tx |
4 - 15 % of glial tumors, average age at presentation is 40y, male to female ratio 3:2. Predilection for frontal lobes. 50 - 80% present with seizures. Calcifications seen in ~90% of cases. Tx: Cx + chemo, XRT somewhat controversial. |
|
|
Origin of meningiomas
|
Meningiomas arise from arachnoid cap cells
|
|
|
Meningioma ratio male:female and what percentage are multiple. Are increased in which situations. Grades of meningiomas
|
Meningiomas can be G-I, G II (atypical) and G III malignant (Anaplastic-malignant -rhabdoid and papillary type) (extremely rare but can metastazise). |
|
|
Which is the most common primary intracranial tumor an is most common at what age
|
Meningeoma and incidence peaks around 50 @ (most meningiomas remain asymptomatic through the patients life). |
|
|
Parasagital meningiomas in the middle (coronal suture to lamboid suture) what is the percentage and which presentatios is the most common. In lesions involving the tentorium in angiography which artery can be enlarged |
In meningiomas involving the tentorium the artery of bernasconi and Cassinari "italian artery" can be enlarged. |
|
|
Grading system (Sindou) for sinus invasion in meningiomas |
I. Attachment to the lateral wall. II. Attachment to the lateral wall and invasion of lateral recess. III. Invasion of lateral wall. IV. Invasion of lateral wall and roof. V. Total occlusion of sinus with lateral wall spared. VI. Total sinus occlusion with invasion of all walls. |
|
|
Olfactory groove meningioma is usually asymtomatic until large when it can produce which syndrome (S&S) |
Foster Kennedy syndrome (wich can be seen with other frontal tumors compressing one optic nerve and causing increased ICP). S&S: anosmia, ipsilateral optic atrophy (central scotoma) and contralateral papilledema). |
|
|
Simpson grading system for removal of meningiomas
|
V grades (recurrence at follow up of 10 y) I. Complete removal with excision of dural attachment and abnormal bone (9 %) II. Complete removal with coagulation of attachment (19%) III. Complete removal without resection or coagulation of dural attachment (29%) IV. Partial removal leaving tumor in situ (40%) V. Simple decompression (+/- biopsy). |
|
|
Characteristics of hemangiopericytoma |
Rare, surgical tx, tend to recur. XRT may reduce recurrence. ***May mimic meningioma on CT or MRI. |
|
|
Vestibular schwannoma arises from? Usual age of presentation? and unilateral vs bilateral? |
- Unilateral in 95% of cases usually sporadic and presents in the 5th - 6th decades of life. - Bilateral 5% and is pathognomonic of NF II. Usually in younger pts. Note any patient < 40yo should be evaluated for NF II. - One of the most common intracranial tumor and ~ 75 - 90% of CPA masses. |
|
|
Histology of vestibular schwannomas
|
Comprised of Antoni A and Antoni B fibers and also Verocay bodies are seen.
|
|
|
Vestibular schwannoma sings and symtoms.
|
S&S: Clinical triad hearing loss (98%) tinnitus (70%) and desequilibrium (67%). - Other symptoms: facial numbess (29%) facial weakness (10%). Weber test lateralizes to oposite side and Rinne is positive. Nistagmus 26% - 33% abnormal corneal reflex ~ Afferent V1 and efferent VII |
|
|
Vestibular schwannoma MRI characteristics and other modalities for evaluation
|
- T1 hypo-isodense may contain hypointense cystic areas. + contrast enhances vividly. - T2 heterogeneously hyperintense. |
|
|
In the treatment of vestibular schwannomas which is the actual radiation dose and which drug is promising for schwannoma associated with NF type II |
The recomended radiation doses are between 12 to 14 Gy. Drug is bevacizumab (Avastin). |
|
|
Treatment recomendations for schwannoma? size? What can happen after radiotherapy? and what kind of tumors XRT can trigger?
|
- Intracanalicular non-cystic size < 2cm observe. - Tumor > 1.5 - 2 cm should be treated. - After XRT there maybe an increase in the size of the tumor so Cx should be avoided 6-18 months after XRT (maximal damage from XRT). - XRT has a potential to induce malignant transformation including triton tumors (malignant non-neoplasm with rhabdoid features). |
|
|
In anaplastic oligodendroglioma, which mutations are related to a much better prognosis |
- Deletion of the 1p and - Deletion of the 19q |
|
|
In anaplastic oligodendroglioma, which mutations or the lack of are related to a much worst prognosis
|
- No TP53 mutation |
