[ Neurosurgery ] Brain tumor 4

Choroid plexus papilloma – treatment and surgical complications

Excision, complicated by bleeding or dural fistula.

Pediatric posterior fossa tumors – examples

Pilocytic astrocytoma and medulloblastoma.

Pediatric brain tumors – most common malignant vs benign

Medulloblastoma is the most common malignant, pilocytic astrocytoma the most common benign.

Pediatric posterior fossa tumors – presentation

Ataxia, nystagmus, dysmetria, dysdiadochokinesia, and raised ICP.

Pediatric posterior fossa tumors – investigations

Brain CT or MRI, and whole spine MRI with contrast for drop metastases.

Drop metastases – tumors and origin

Medulloblastoma (most common CSF seeding, arises from the cerebellum) and ependymoma (arises from the floor of the 4th ventricle).

Pediatric posterior fossa tumors – contraindicated procedure

Lumbar puncture, due to risk of herniation.

Solid midline infratentorial tumor in a child

Medulloblastoma or ependymoma.

Facial colliculus – location and contents

Elevation in the pons (floor of the 4th ventricle) housing the abducens nucleus and facial motor fibers.

Sellar or suprasellar tumor in children

Craniopharyngioma (with calcification).

Sellar tumor in adults

Pituitary adenoma, most commonly prolactinoma.

Prolactinoma – presentation

Amenorrhea, galactorrhea, mass effect (bitemporal hemianopia), and hypopituitarism.

Prolactinoma – investigation

Prolactin level.

Prolactinoma – treatment

Cabergoline or bromocriptine medically, transsphenoidal hypophysectomy surgically.

Extradural spinal tumors – examples

Metastasis and lymphoma.

Intradural extramedullary spinal tumors

Meningioma and schwannoma (NF2).

Spinal metastases – possible location

Can be intradural intramedullary.

Spinal tumors – most common site

Thoracic.

Spinal tumors – presentation

Axial pain (lumbar, neck) and sensory and motor deficits.

Spinal lipoma – location and presentation

Intradural extramedullary, with unilateral ascending weakness.