Step 1: Neuro Iv Tumors & Herniations

Front 1

Most common primary brain tumor in adults?
- location?
- histo appearance?
- stain for what?

Back 1

Glioblastoma multiform (grade IV astrocytoma)
- i/ cerebral hemispheres; can cross corpus callosum ("butterly glioma")
- "pseudopalisading" pleomorphic tumor cells around areas of necrosis and hemorrhage
- stain astrocytes for GFAP.

Front 2

"pseudopalisading" pleomorphic tumor cells around areas of necrosis and hemorrhage... think which tumor?

Back 2

Glioblastoma multiforme

Front 3

Tumor in brain that most often occurs in convexities of hemispheres and parasagittal region...
- arises from which cells?
- tx?
- seen on histo?

Back 3

Meningioma
- arachnoid cells external to brain
- resectable
- psammoma bodies, w/ spindle cells concentrically arranged in a whorled pattern

Front 4

spindle cells concentrically arranged in a whorled pattern... think which primary brain tumor?

Back 4

Meningioma

Front 5

Tumor that most often localizes to CN VIII?
- prog?
- state it's location another way?
- marker + for?

Back 5

Schwannoma
- resectable
- cerebellopontine angle
- S-100

Front 6

Cells with round nuclei and CLEAR cytoplasm... there can be calcifications. Tumor?
- freq?
- speed of growth?
- other things to note histologically?
- most often found where?

Back 6

Oligodendroglioma (image 49 in first aid)
- relatively rare
- slow
- "chicken-wire" appearance of capillaries i/b/t cells.
- frontal lobes (think frontal lobe syndromes, I guess (executive fx, etc).

Front 7

Most common type of pituitary adenoma?
- famous sx?

Back 7

prolactinoma
- bitemporal hemianopia.

Front 8

Where are the childhood tumors found?
- exceptions (2)?

Adult?
- 1 exception?

Back 8

Infratentorially.

Two found supratentorially:
- pilocytic astrocytoma, but unlike the adult form it tends to show up in the posterior fossa.
- Craniopharyngioma (remants of rathke's pouch with teeth calcifications/enamel)

Supratentorially

- Pituitary adenoma (infratentorially)

Front 9

GFAP positive tumor in posterior fossa in child....
- benign/malig?
- histological appearance?
- gross appearance?

Back 9

Pilocytic (low grade) astrocytoma.
- benign
- eosinophilic, corkscrew fibers.
- Cystic + solid

Front 10

eosinophilic, corkscrew fibers (Rosenthal fibers) seen in a childhood primary brain tumor. Dz?

Back 10

Pilocytic astrocytoma.

Front 11

Rosettes or perivascular pseudorosette pattern of cells in childhood tumor...
- location
- prog
- name of tumor
+ a form of what?
- common complicating sx?
- tx?
- histological appearance?
- gross?

Back 11

- cerebellar tumor
- highly malignant
- Medulloblastoma
+ PNET
- compress 4th ventricle, causing hydrocephalus
- Radiation sensitive.
- <mentioned above> + small blue cells
- solid

Front 12

Which tumor of childhood can compress the 4th ventricle, causing hydrocephalus?

Back 12

Medulloblastoma, Ependymoma can cause it too.

Front 13

Type of childhood tumor most often found in 4th ventricle...
- histology
- prog?

Back 13

Ependymoma
- perivascular pseudorosettes. rod-shaped blepharoplasts (basal ciliary bodies) found near nucleus.
- poor

Front 14

circles of cells near vasculature, with rod-shaped inclusions near nuclei... tumor?

Back 14

Ependymoma tumor is a kid (found in 4th ventricle).

Front 15

If you see foamy cells, with a high vascularity i/a childhood tumor, think what?
- where would you expect to see this?
- can be seen with ______, which associates the whole thing with which syndrome?
- can produce what paraneoplastically?

Back 15

Hemangioblastoma
- i/cerebellum.
- retinal angiomas, Von Hippel Lindau dz.
- EPO --> 2ndary polycythemia

Front 16

What tumor of childhood can be confused with pituary adenoma? why?
- location?
- derived from?
- seen in histo/gross?

Back 16

Craniopharyngioma; it can also cause bitemopral hemianopsia.
- SUPRAtentorial (exception to normal rule)
- Rathke's pouch
- calcifcation is common (tooth, enamel like)

Front 17

Visualize the four types of herniation, and tell me what fuckups they can cause.

Back 17

Cingulate (subfalcine), can compress ACA.

Downard transtentorial (central) herniation ... can cause coma and death if brainstem is compressed

Uncal herniation (medial temporal lobe is herniated transstentorially)

Cerebellar tonsillar herniation into the foramen magnum

Front 18

Uncal herniation can cause a bunch of signs... give me the 4 causes, and WHAT they cause.

Back 18

(1) Stretching of CN III (innervates levator palpebrae) --> ipsilateral dilated pupil/ptosis

(2) compression of ipsilateral PCA --> contraleral homonymous hemianopia (bilateral loss of the contralateral vision field)

(3) Compression of contralateral crus cerebri (Kernohan's notch) --> ipsilateral paresis

(4) Caudal displacement of brainstem --> paramedian artery rupture (Duret hemorrhages)

Front 19

Ring-enhancing lesion --> DDx? (4)

Uniformly enhancing lesion?

Heterogeneously enhancing lesion?

Back 19

mets, abscesses, toxoplasmosis, AIDS lymphoma

Lymphoma, meningioma, mets (though they're usually ring-enhancing)

Glioblastoma multiforme.