Gliomas (neoplasms)

High Grade Astrocytomas

-diffusively infiltrative that invade cerebral parenchyma -mix of cells and cell grades -rapidly growing, highly vascular -frontal and temporal lobes -HA, lethargy, memory loss, motor weakness and personality changes

Primary CNS lymphoma

occurs in absence of systemic lymphoma in deep white matter, basal ganglia, corpus callosum and thalamus

Gliomas, what are they?

tumors of glial cells which support, insulate and metabolically assist the neural tissue

Hemangioblastoma

-intraaxial tumor of posterior fossa -benign slow growing, in cerebella vermis or pons

Pituitary Adenoma

-benign -anterior portion of pituitary gland -middle aged or older -women more than men -arise from single somatic cell -can compress optic chaism -signs of pituitary malfunction

Choroid Plexus Papilloma

-in choroid plexus that carries blood to vascular coat

Gliomas risk factors

-none except for ionizing radiation -infection, trauma and immunosuppression may be other triggers -not from cell phones or household appliance

Chordoma

-posterior cranial fossa -rare in axial skeleton

Ependymoma

-prevalent in children in posterior fossa -from cell lining of ventricular system and central canal of SC -reddish, cauliflower shape -4th ventricle -HA, nausea, committing and papilledema

Pinealoma

-rare in pineal region posterior to 3rd ventricle -highly malignant and incureable

Neurinoma

-slow growing, benign -originate from schwann cells -internal auditory canal -compresses facial nerve -hearing loss, vertigo -facial weakness -cure with surgery

Meningioma

-slow growing, benign -originate in arachnoid layer -40-70 years old -increased incidence in neurofibromatosis, postmenopausal hormone replacement therapy and breast cancer pts - globular masses that cause profuse thickening of skull by invading bone

Low Grade Astrocytomas

-star shaped cells -mostly in frontal lobes in adults -unilateral or focal HA that become generalized as ICP increases -in cerebellum with children causing unilateral cerebellar ataxia Prognosis: 5-10 year survival rate, always infiltrative and generally progressive

Oligodendroglioma

-young and middle aged adults, but can occur in children -slow growing, solid, calcified tumor arising from oligodendrocytes -appears pink or red -cerebral hemispheres, expand toward cortex -**calicification seen on CT with limited surrounding edema

Glioma types

1. low grade astrocytomas 2. high grade astrocytomas 3. oligodendrogliomas 4. ependymoma 5. meduloblastoma

Tumors from supporting brain structures

1. meningioma 2. pituitary adenoma 3. neurinoma, neuroma 4. choroid plexus papilloma 5. pinealoma 6. craniopharyngiomas 7. epidermoid and dermoid 8. chordoma 9. primary CNS lymphoma

Medulloblastoma

45-55 years old, 2-10 years old -posterior fossa in children -rapidly growing malignant tumor -from external granular layer of cerebellum -red, soft, comprised of packed cells, highly vascular -hydrocephalus common, ataxia

Astrocytomas: grades

Grade 1 or 2: low grade glioma Grade 3: high grade or anaplastic astrocytoma Grade 4: glioblastoma or malignant astrocytic glioma

Epidermoid and Dermoid

benign arise from imperfect embryogenesis of CNS

Craniopharyngoimas

benign occur in pituitary stalk next to optic chaism

Gliomas 2 categories

benign or low grade malignant men affected more than women 3:2 ratio