The most common type of primary brain tumour is…
Glioma
Over half of all brain tumours are…
Metastatic
Which primary cancers are associated with brain metastases?
PoRTaBLe:
- Prostate
- Renal
- Thyroid
- Breast
- Lung
What are the clinical features of brain tumour?
Raised ICP:
- Headache (made worse by lying down, bending forwards, coughing)
- Vomiting
- Papilloedema
- Seizure
Focal neurology (varies depending on site of lesion)
‘Red flag’ symptoms (cancer):
- Weight loss
- Malaise
- Night sweats
Describe the investigation of suspected brain tumour
Brain imaging (CT/MRI)
Describe the management of brain tumour
- Neurosurgery
- Radiotherapy
Which nerve is affected if a patient develops wrist drop?
Which fracture is associated with this presentation?
- Radial nerve
- Fracture of the shaft of the humerus
Which nerve is affected if a patient develops foot drop?
Peroneal nerve
What are the three components of the Glasgow Coma Scale (GCS) and what are they scored out of?
- Eye opening (scored out of 4)
- Verbal response (scored out of 5)
- Motor response (scored out of 6)
Explain the scoring criteria for each of the components of the GCS score
Eye opening:
- Spontaneous
- To speech
- To pain
- None
Verbal response:
- Orientated
- Confused
- Words
- Sounds
- None
Motor response:
- Obeys commands
- Localises to pain
- Withdraws from pain
- Flexion to pain
- Extension to pain
- None
What is the minimum possible GCS score?
3
What is the mechanism of inheritance of tuberous sclerosis?
Autosomal dominant
Give some examples of clinical features of tuberous sclerosis
Clinical features are mostly neurocutaneous…
Cutaneous:
- Depigmented ‘ash leaf’ spots
- Rough patches of skin over lumbar spine (Shagreen patches)
- Angiofibroma (butterfly distribution over nose)
Neuro:
- Epilepsy
- Developmental delay
What are the types of neurofibromatosis?
Which type is more common?
Two types - NF1 and NF2
NF1 is more common
Both forms of neurofibromatosis are inherited in the same way - describe the pattern of inheritance
Autosomal dominant
Describe the clinical features of NF1 and NF2
NF1:
- Cafe au lait spots
- Peripheral neurofibromas
NF2
- Bilateral vestibular schwannomas
What are the symptoms of normal pressure hydrocephalus?
Triad:
- Cognitive impairment
- Ataxia
- Urinary incontinence
What are the clinical features of Horner’s syndrome?
Give some causes of Horner’s syndrome.
Clinical features:
- Ptosis
- Miosis (small pupil)
- Anhidrosis (loss of sweating on one side)
Causes:
- Stroke
- Tumour
- Trauma
Do cranial nerve lesions cause an ipsilateral or contralateral deficit?
Ipsilateral
Which nerve is affected if a patient cannot abduct the thumb?
Which fracture is commonly associated with this presentation?
Median nerve
Colle’s fracture (distal radius)
What kind of visual field defect would you get as a result of a…
i) Pituitary adenoma
ii) Craniopharyngioma
i) Bitemporal superior quadrantanopia
ii) Bitemporal inferior quadrantanopia
