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CNS Tumor. Intracranial tumors can be classified in different ways: 1. primary versus secondary, 2. pediatric versus adult, 3. cell of origin, 4. location in the nervous system. the incidence of primary brain tumors 14.8 per 100,000 person-years. Clinical Presentation.
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Intracranial tumors can be classified in different ways:1. primary versus secondary, 2. pediatric versus adult, 3. cell of origin, 4. location in the nervous system.
the incidence of primary brain tumors 14.8 per 100,000 person-years
Clinical Presentation The clinical manifestations of various brain tumors can best be divided into those due to focal compression and irritation by the tumor itself and those attributed to the secondary consequences, namely increased ICP, peritumoral edema, and hydrocephalus. Most commonly, symptoms are caused by a combination of these factors.
The clinical presentation does not differ much by tumor histology but rather by rate of growth and location of the tumor.
Headache occurs in 50% to 60% of primary brain tumors and in 35% to 50% of metastatic tumors. The headache is associated with nausea and vomiting in 40% of patients and may be temporarily relieved by vomiting, as a result of hyperventilation.Seizures may be the first symptom of a brain tumor. Patients older than 20 years presenting with a new-onset seizure are aggressively investigated for a brain tumor.
Location of tumorInfratentorial lesionsSupratentorial lesions Frontal lobe lesions Temporal lobe lesions Parietal lobe lesions Occipital lobe lesions
Frontal lobetumor Central groove Central groove
Temporal lobetumor glioma
Parietal lobetumor Glioma meningoma Metastatic tumor Parietal lobe
Occipital lobetumor Contralateral visual field deficits
Therapy of brain tumor Surgery Radiologic therapy Chemotherapy Immunotherapy
Surgery The primary goals of surgery include histologic diagnosis and reduction of ICP by removing tumor.
Primary tumors of the brain are divided into intra-axial (those arising from within the brain parenchyma) or extra-axial (those arising from outside the brain parenchyma).
Intra-axial Brain TumorsThe World Health Organization (WHO) classifies intra-axial brain tumors by cell type and grades them on a scale of I to IV based on light microscopy characteristics that include degree of cellularity, pleomorphism, mitotic figures, endothelial proliferation, and necrosis. The higher the grade, the more aggressive and malignant the tumor.
Intra-axial Brain Tumors1. Astrocytoma 2. Oligodendroglioma 3. Ependymoma 4. Primitive Neuroectodermal Tumors 5. Hemangioblastoma 6. Primary Central Nervous System Lymphoma
Extra-axial Brain Tumors1. Meningiomas 2. Schwannomas 3. Pituitary Adenomas
Intraspinal Tumors Intraspinal tumors are commonly divided into three groups: 1. extradural 2. intradural extramedullary 3. intramedullary
SummaryPrimary Brain Tumors Intra-axial Brain TumorsExtra-axial Brain TumorsSecondary Brain Tumors
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