neurology

1. Brain tumors

2. A brain tumor or intracranial neoplasm occurs when abnormal cells form
within the brain
What is tumor?
What is brain tumor?

3. Kinds of tumor?
There are two main types of tumors: malignant or cancerous tumors
and benign tumors.[1]
Cancerous tumors can be divided into primary tumors that started within the brain and
those that spread from somewhere else known as brain metastasis tumors
most dangerous?
Beningn or malignant
Both are dangerous incase of brain tumors

4. These tumors don not have premalignant or insitu stages
Even low grade lesions may infiltrate large regions of the brain leading to a serious
clinical deficits,non resectionability and poor prognosis
The anatomic site of the neoplasm can influence outcome on different organ(eg..,
beningn meningioma may cause cardiorespiratory arrest from compression of the
medulla)
Even the most highly malignant tumor rarely spread out of CNS. But the local
infiltration spread to distant areas along th neurotaxis through? Sub arachanoid space
Unique feature;-

5. .
Diagnosis;-
CT computed tomography

6. Magnetic resonance imaging

7. Biopsy

8. Treatment
radiotherapy,

9. chemotherapy

10. surgery

11. People with brain tumors often suffer from:
Headaches
Seizures
Sensory (touch) and motor (movement control) loss
Deep venous thrombosis (DVT, or blood clot)
Hearing loss
Vision loss
Fatigue
Depression
Behavioral and cognitive (thinking) changes
Endocrine dysfunction (hormone/gland changes)

12. causes
Age
Medical radiation
Genetic conditions and family history ---- Neurofibromatosis type 1 and 2
Tuberous sclerosis
Li-Fraumeni syndrome
Von Hippel-Lindau syndrome
Turner syndrome
Turcot syndrome
Gorlin syndrome
Other medical conditions and medicines
Body size and exercise
Other possible risk factors ----- Power lines
Mobile phones
Hair dye
Smoking and alcohol

13. Tumors of the brain
Glioma Astrocytoma:- diffuse astrocytoma, pilocytic astrocytoma,
Oligodendroglioma
Ependymoma
Neuronal tumors central neurocytoma, ganglioglioma, dysembryoplastic neuroepithelial tumor
Embryonal (primitive)
neoplasms
Other parenchymal
tumors
Meningioma Metastatic tumors
medulloblastoma
Germ cell tumors

14. Glioma
Astrocytoma:- diffuse astrocytoma,
pilocytic astrocytoma,
Oligodendroglioma
Ependymoma

15.  Mostly in adults
 80% of the adult gliomas are considered as diffuse astrocytoma
 Especially in fourth to sixth decade
 This kind of tumor mostly found in cerebral hemispheres
 Symptoms :- seizures,headache, mood swings, neuralgia defect on the affected site
 Genetic findings;
Loss of function by mutuations in the p53 and Rb tumor suppressor
Gain of function in the oncogene p13k pathways
 These mutations also alter the enzymatic activity of IDH1 and IDH2
 Diagnosis :- immunostaining in the biopsy specimen is the best procedure for conclusion
Diffuse astrocytoma

17. pilocytic astrocytoma
mostly vulnerable in children and in young adults
Region :- cerebellum and also in third ventricle (may be in optic pathway)
tumors in hypothalamus region are especially problematic
why?
because they cannot be resected completely
symptoms
Lack of appropriate weight gain, headache, nausea, vomiting, irritability, torticollis (tilt
neck or wry neck) difficulty to coordinate movements and visual complaints (including
nystagmus).
Genetic findings :-Because of mutations in the serine threonine kinase

19. Oligodendroglioma
They are 5 to 15% of gliomas
Vulnerable in the age 30-50 yrs
Mostly in cerebral hemisphere especially in frontal and temporal lobes
Unlike astrocytoma they have better prognosis
Survival rate is 10 – 15 yrs
Genetic findings:- deletion of chromosome 1p and 19q
Tumors with this genetic deletion are highly responsible for chemo and
radiotheraphy

20. • Round nuclei with fine chromatin
• surrounded by halo of cytoplasm
• Calcification

21. Ependymoma
5 to 10% of glioma
Age onset :- first 2 decades
Most vulnerable region :- 4th ventricle
In adults mainly in spinal cord especially in central canal
They mostly arise next to ependymalined ventricular system

23. Neuronal tumors
central neurocytoma,
ganglioglioma,
dysembryoplastic neuroepithelial tumor

24. central neurocytoma
With in and adjacent to ventricular system
Characterized by evenly spread , round, uniform nuclei, and often
island of neuropil

25. Ganglioglioma
It is a mixture of glial cells and astrocytoma
They are slow growing tumors
Mostly in temporal lobe
Irregularly clustered with neurites

26. Dysembryoplastic neuroepithelial tumor
 These are Childhood tumor
 Most appropriate region is in the supratentorial region
 Grows slowly
 Good prognosis after resection
 They form multiple discrete intracortical nodules, floating
neurons

28.  Tumors of neuroectoderm origin have a
primitive small round cell which look like
progenitor cells
Which are responsible for the developing
of CNS
The most common embryonal neoplasm is
medulloblastoma
Embryonal neoplasm

29. medulloblastoma It is malignant
 20% of pediatric brain tumor
 Exclusively in cerebellum
 Prognosis for untreated person is so horrible
 These tumors have increased neutropin receptors or
elevated intranuclear beta-catenin
 The tumors are radiosensitive but the suggested
treatment is chemotheraphy or surgical resection
because it is best to avoid CNS radiotheraphy in
children
 5 year of survival is possible

31. Germ cell tumor
 Accur along the pineal and suprasellar regions
 Tumors of young especially in first and second
decades
 90% of parenchymal tumors are germ cell
tumors
 The male has the most predominance
 The most common germ cell tumor is
germinoma

32. meningiomas
It is usually occur in adults
Arise from the arachanoid cells and often attaches
to the dura.. They may also found in brain as well
as in ventricular system?
They are easily seperable
When a person has multiple meningioma especially
in association with glial tumor. Diagnosis of
neurofibromais-2 is considered

33. Metastatic tumor
Most common primary sites are lung , breast,skin,kidney,and G.I tract
They form masses often at the grey - white matter junction and elicit edema

34. A 11 years old boy appearing to you with the symptoms of headache,vomiting,loss of apetite.by inspection he looks too thin and
very calm,and his skin is so dry.for further investigation(palpation) you made him to lie and when you starts your procedure
suddenly the boy goes aggressive and scolding you and not permitting you to do your procedures unexpectedly he got seizures so
you concluded that this patient has confirmed neurologic problem.after treating with antiseizure medications he was sent for the
radiological,cytological,immunological investigations.
The results arrived let us go and check

35. Radiological cytological

38. References
Michael J. Mastrange seminar of oncology
Robbins pathology
www.cancerresearchuk.org
Thank you