-
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
-
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
-
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
-
What are the primary cancers that may cause brain mets?
- Most common: breast, lung
- Cancers with predilection: melanoma, testicular ca, RCC, thyroid ca
-
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
-
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
-
What are the DDx for a ring-enhancing lesion on brain MRI?
- Metastatic tumour
- Brain abscess
- Toxoplasmosis
- Tuberculosis
- Lymphoma
|
|
