[ Neurosurgery ] Brain tumor 2

GBM – frequency

Most common primary glioma.

GBM – features

Surrounded by vasogenic edema, with areas of necrosis and vascular proliferation.

GBM – treatment and prognosis

Surgery and chemoradiotherapy, poor prognosis.

GBM – IDH classes (per lecture)

IDH-wild type (most common) and IDH-mutant type.

Ring-enhancing lesion on MRI – differential (examples)

GBM, brain abscess, metastasis, subacute stroke, and resolving ICH.

Pilocytic astrocytoma – grade and age

Circumscribed grade I astrocytoma, in 1st or 2nd decade of life.

Pilocytic astrocytoma – significance

Most common benign brain tumor in children.

Pilocytic astrocytoma – location and prognosis

Infratentorial (obstructive hydrocephalus), excellent prognosis if completely resected.

SEGA – grade and location

Grade I astrocytoma between the lateral and 3rd ventricles, adjacent to the foramen of Monro.

SEGA – association

5 to 15% of patients with tuberous sclerosis.

Optic glioma – features

More in children, associated with NF1, bilateral, sparing the optic chiasm.

Meningioma – frequency

15 to 20% of intracranial neoplasms.

Meningioma – epidemiology

Most common extra-axial tumor, more in adult females.

Meningioma – nature

Mostly benign, highly vascular, and slowly growing.

Meningioma – cell of origin

Arachnoid cap cells.

Meningioma – most common sites

Parasagittal (25%), convexity (19%), sphenoid ridge (17%), and suprasellar (9%).

Meningioma in adults – multiplicity

Usually single, if multiple think of NF2.

Meningioma in children – features

1 to 4% of cases, M:F 1:1, more malignant, associated with NF2.

Meningioma – main blood supply

External carotid artery.

Meningiomas supplied by the internal carotid artery (examples)

Olfactory groove (anterior and posterior ethmoidal arteries from the ophthalmic), intraventricular, and tentorial.