Armando Hasudungan

Biology and Medicine Tutorials

Brain Tumour

Overview

Definition
Brain tumours: refers to a mixed group of neoplasms originating from intracranial tissues and the meninges with degrees of malignancy ranging from benign to aggressiv

Classification

WHO Classification of Primary Brain Tumors
Neuroepithelial tumors
Astrocytic tumors
Oligodendroglial tumors
Oligoastrocytic tumors
Ependymal tumors
Choroid plexus tumors
Neuronal and mixed neuronal-glial tumors
Pineal tumors
Embryonal tumors
Tumours of cranial and paraspinal nerves
Schwannoma
Neurofibroma
Perineurioma
Malignant peripheral nerve sheath tumor
Tumours of the meninges
Meningioma
Lymphomas and hematopoietic neoplasms

Common Brain Tumour in children

  • Pilocytic astrocytomas
  • Ependymoma
  • Medulloblastoma

Common Brain Tumours in adults

  • Diffuse astrocytic tumours
  • Oligodendrogliomas
  • Meningiomas

 

Benign vs. Malignant

PRIMARY MALIGNANT INTRACRANIAL TUMOURS

Histological typeCommon siteAge

 

Glioma (astrocytoma)Cerebral hemisphere
Cerebellum
Brain stem		Adulthood
Childhood/adulthood
Childhood/young adulthood
OligodendrogliomaCerebral hemisphereAdulthood
MedulloblastomaPosterior fossaChildhood
EpendymomaPosterior fossaChildhood/adolescence
Cerebral lymphoma (microglioma)Cerebral hemisphereAdulthood

 

 

PRIMARY BENIGN INTRACRANIAL TUMOURS

Histological typeCommon siteAge

 

MeningiomaCortical dura Parasagittal Sphenoid ridge Suprasellar Olfactory grooveAdulthood
NeurofibromaAcoustic neuromaAdulthood
CraniopharyngiomaSuprasellarChildhood/adolescence
Pituitary adenomaPituitary fossaAdulthood
Colloid cystThird ventricleAny age
Pineal tumoursQuadrigeminal cisternChildhood (teratomas) Young adulthood (germ cell)

Risk Factors

Signs and Symptoms

Remember Seizures are the presenting symptom in 25% of tumours.

ICP

Common Signs and Symptoms

  • Headache
  • Memory loss
  • Cognitive changes
  • Motor deficit
  • Language deficit
  • Seizures
  • Personality change
  • Visual problems
  • Changes in consciousness
  • Nausea or vomiting
  • Sensory deficit
  • Papilledema

Differential Diagnosis

  • Infection (pyogenic abscess, tuberculoma, parasitic cysts)
  • Vascular lesion (haematoma, infarct with oedema and peripheral luxury perfusion, AVM, giant aneurysm).
  • Traumatic haematoma
  • Inflammatory lesion

Investigations and Diagnosis

  • CT
  • MRI
  • Cerebral angiogram

 

Remember Earlier diagnosis of brain tumours in children and young adults improves long term outcomes

Pathophysiology

Management

Complications and Prognosis

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