intracranial neoplasma
DESCRIPTION
Intracranial NeoplasmaTRANSCRIPT
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INTRA CRANIAL NEOPLASMNurdjaman Nurimaba dr, Sp.S(K)Neurological DepartmentMedical Faculty, Padjadjaran University
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INCIDENCEIn 1983 estimated 400.000 deaths from cancer in USA Patient dying of primary tumors of the brain 12.000, but in another 70.000 to 80.000 mainly by metastases
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CAUSATIONAntecedent : - Head injury - Infection - Metabolic and other systemic disease - Exposure to toxins and radiation - Genetics - Embryonic cell - Carcinogen
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Tumors rise from vestigial tissues : - Craniopharyngiomas, teratomas, lipomas and chordomas Tumors from rest of glioblast : -Gliomas Genetics disease : - Von Reckling Hausen neurofibromatosis, tuberousclerosis, hemangioblastomatosis
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Certain midline tumors of closure of neuraltube : polar spongioblastoma, retinoblastoma, gliomas of optic nerve, hypothalamus, cerebellum and spinal cord.
The factor of age : - medulloblastoma, polar spongioblastoma (piloid astrocytomas), pinealomas occur before the age of 20 years
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Meningiomas, glioblastomas, frequent around the age of 50 yearsCarcinogen : Hydrocarbons and nitrosamins could cause a variety of gliomas Concepts of pathogenesis of primary tumor of the CNS ; 1. Histogenic theory 2. Neoplastic transformation
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Types of intracranial tumors
Tumor
Percent of total
Gliomas :
Glioblastoma multiforme
Astrocytoma
Ependymoma
Medulloblastoma
Oligedendrocytoma
20
10
6
4
5
Meningioma
15
Pituitary adenoma
7
Neurinoma (Schwannoma)
7
Metastatic carcinoma
6
Craniopharyngioma, teratoma
4
Angiomas
4
Sarcomas
4
Unclassified (mostly gliomas)
5
Miscellaneous(pinealoma, chordoma)
3
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CLINICAL SYMPTOMGeneral evidence of increased intracranial pressure : - Headache - Nausea and vomiting - Seizure - Decrease conciousnes Focal symptom : - Hemianopsi homonim, false localizing sign - Change in mental function , sensation - Change hormonal function
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Neoplasm intracranial can cause herniation : - Falx herniation - Trans tentorial herniation - Tonsilar herniation - Uncal herniation
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NeuroepitNeuroepithelial tumors :
Neuronal tumors :
Germ cells tumor
Astrocytic tumors :
Ganglioblastoma
Germinoma
Diffuse astrocytoma
Gangliocytoma
Embryonal carcinoma
Anaplastic astrocytoma
Primitive neuroectodermal tumor;
Choriocarcinoma
Teratoma
Glioblastoma multiforme
Medulloblastoma
Malignant lymphomas :
Juvenile pilocytic astrocytoma
Pineoblastoma
Hodgkin's disease
Neuroblastoma
Non Hodgkin's L.
Subependymal giant cell astrocytoma
Meningeal tumors
Meningioma
Malformative tumors :
Craniopharyngioma
Oligodendroglioma tumor :
Papillary meningioma
Epidermoid Cyst
Oligodendroglioma
Anaplastic meningioma
Dermoid Cyst
Anaplastic oligodendroglioma
Neuroepithelial (colloid) cyst
Nerve sheath tumors :
Ependymal tumors :
Schwannoma (Neurilemoma)
Lipoma
Ependymoma
Regional tumors :
Myxopapillary
Neurofibroma
Chordoma
ependymoma
Neurofibrosarcoma
Glomus jugulare tumor
Anaplastic ependymoma
Tumors of blood vessel origin :
Chondroma
Subependymoma
Metastatic tumors
Choroid plexus tumors :
Hemangioblastoma
Carcinoma
Choroid plexus papiloma
Hemangiopericytoma
Sarcoma
Choroid plexus carciaoma
Lymphoma
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TYPE OF THE TUMORPrimary tumor : - 90 - 94 % from the intracranial neoplasm, can cause from parenchyma cells, meningen, vascular, hypophyse, embryonalcells, neural sheats Secondary tumors (metastatic tumors): - 5 % - Lungs, bone, thyroid, mammae, cervix, prostate
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TOPOGRAPHYSupra tentorial: - Hemispheric : 1. Astrocytoma 2. Glioblastoma 3. Metastasis 4. Meningioma 5. Lymphoma - Sellar zone : 1. Pituitary adenoma 2. Craniopharyngioma 3. Meningioma 4. Optic and hypothalamic glioma
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- Pineal zone : 1. Pineocytoma 2. Pineoblastoma 3. Germinoma 4. Astrocytoma 5. Metastasis
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Infratentorial tumors : - Midline : Pediatric 1. Medulloblastoma 2. Ependymoma 3. Pontine glioma Adult 1. Pontine glioma 2. Schwannoma 3. Meningioma 4. CP papilloma 5. Metastasis
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- Cerebellar hemisphere : Pediatric 1. Juvenile Astrocytoma Adult 1. Hemangioblastoma 2. Astrocytoma 3. Metastasis 4. Medulloblastoma
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Malignant tumors : 1. Astrocytoma grade III & IV 2. Ependymoma grade I - IV 3. Oligodendroglioma 4. Medulloblastoma 5. NeuroastrocytomaBenign tumors : 1. Meningioma 2. Craniopharyngioma 3. Neurolemoma
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Foster-Kennedy Syndrome - Fronto basal tumor symptom : 1. Papil atrophy ipsilateral 2. Anosmia ipsilateral 3. Papil oedema contralateral
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LABORATORY EXAMINATIONScheedel photo : - Erosion of posterios dorsum sella - Ballooning sella - Impression digitate Angiography CT ScanMRI
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TREATMENTMedicamentous : - Corticosteroid - Mannitol - Anticonvulsan Operative Radiation : - Curative : Medulloblastoma - Decrease of exacerbation: Astrocytoma, oligodendroglioma, ependymoma, chordoma, metastasis Chemotherapeutica
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PROGNOSISMalignant tumors : Non SatisfiedBenign tumors : Good
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HATUR NUHUN