Brain tumors

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Neurology Mind Map on Brain tumors, created by LewisLewis on 05/13/2014.
LewisLewis
Mind Map by LewisLewis, updated more than 1 year ago
LewisLewis
Created by LewisLewis almost 11 years ago
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Resource summary

Brain tumors
  1. Classification
    1. Primary tumors
      1. Glial cells
        1. Astrocytes
          1. Tendency to infiltrate
            1. 4 grades
              1. I (Pilocytic astrocytoma)
                1. Main glial tumor of children and it can be typically seen in young adults too
                  1. Usually in the cerebellum
                    1. Rosenthal fibers
                    2. II (Diffuse astrocytoma)
                      1. Most frequent tumor type
                        1. Main morphological types
                          1. Fibrillary astrocytoma
                            1. Protoplasmic astrocytoma
                              1. Gemistocytic astrocytoma
                                1. poorer prognosis than other matched WHO grade tumours
                                  1. Cell cytoplasm is plump and filled with intermediate filaments
                              2. III (Anaplastic astrocytoma)
                                1. increased cellularity, mitosis, vascular arborisation but no necrosis
                                2. IV (Glioblastoma)
                                  1. Giant cell glioblastoma
                                    1. Gliosarcoma
                                      1. Here we have (palisading) necrosis
                                        1. hypoxic tumor and thus it induces VEGF release. Anti-VEGF molecules has been tested but the success was modest
                                      2. Seizures, headaches and focal neurological deficits
                                      3. Most frequent cells giving rise to tumors
                                        1. Oligodendrocytes
                                          1. Oligodendroglioma
                                            1. Seizures
                                              1. Calcifications
                                              2. Anaplastic oligodendroglioma
                                                1. Grade 3
                                                  1. Satellitosis phenomenon
                                                  2. Frontal lobes are the preferred location
                                                    1. Little edema and frequent calcifications
                                                  3. Ependymal cells
                                                    1. Ependymoma
                                                      1. Grade 2
                                                        1. associated to neurofibromatosis type 2 (NF2)
                                                          1. Can cause hydrocephalus, especially in children
                                                            1. More commonly evolve to glioblastomas rather than to grade 4 ependymomas
                                                            2. Choroid papillomas
                                                              1. Choroid cysts
                                                              2. Neural cells
                                                                1. Neuroblastomas
                                                                  1. Found in adrenal glands
                                                                  2. Ganglioneuromas
                                                                    1. Much less frequent than those coming from glial cells
                                                                      1. Frequently found in the thalamus
                                                                        1. Calcifications are present
                                                                          1. Neurocytomas
                                                                          2. Meningeal cells
                                                                            1. Meningiomas
                                                                              1. Homer-Wright rosettes (neuronal rosettes, they doesn’t surround a vessel as for ependymal rosettes) can be visible
                                                                            2. Schwann cells
                                                                              1. Neurinomas
                                                                                1. Neurofibromas
                                                                                2. Melanocytes
                                                                                  1. Embryonic remnants
                                                                                    1. Craniopharingioma
                                                                                      1. Teratoma
                                                                                        1. Germinoma
                                                                                        2. Cholesteatoma
                                                                                          1. Hemangioblastoma
                                                                                            1. cerebellar hemisphere
                                                                                              1. can be associated with VHL and it’s found in patients from the 3rd to the 5th decade
                                                                                            2. Topographic interpretation
                                                                                              1. Intra-arachnoid tumors
                                                                                                1. Intracranial tumors
                                                                                                  1. Supratentorial
                                                                                                    1. Infratentorial
                                                                                                      1. Of the foramen ovale
                                                                                                        1. Foramen magnum
                                                                                                      2. Metastasis
                                                                                                      3. Pathophysiology
                                                                                                        1. Compression
                                                                                                          1. It can lead to edema (vasogenic) by
                                                                                                            1. Treatment
                                                                                                              1. Osmotic diuretics
                                                                                                                1. Osmotic diuretics do not work in edema occurring after infarct because the water is intracellular, and osmotic diuretics cannot extract it
                                                                                                                2. Steroids
                                                                                                                  1. Craniotomy if excessive edema or infarct edema
                                                                                                                  2. The process of the tumor itself increasing the permeability of the vessels
                                                                                                                    1. May depend on neoangiogeneisis which is not so efficient at making the blood-brain barrier
                                                                                                                      1. Compression of veins causing an increased pressure in the venous system
                                                                                                                        1. Pressure can be measured with funds oculi
                                                                                                                          1. Tumor-secreted proteases
                                                                                                                        2. Infiltration
                                                                                                                        3. Symptoms
                                                                                                                          1. Deep coma
                                                                                                                            1. Vomiting
                                                                                                                              1. Due to stimulation of the 4th ventricle
                                                                                                                                1. Intracranial hypertension
                                                                                                                                  1. Bradycardia
                                                                                                                                2. Headache
                                                                                                                                  1. Epileptic seizure
                                                                                                                                    1. Motor problems
                                                                                                                                      1. Signs of cortical involvement
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