BRAIN TUMORS

BRAIN ANATOMY

CLASSIFICATION

I- SECONDARY (METASTATIC) II- PRIMARY : 1- GLIOMAS : a- ASTROCYTOMA (GRADE I-IV) b- MEDULLOBLASTOMA c- OLIGODENDROGLIOMA d- EPENDYMOMA 2- MENINGIOMAS 3- BLOOD VESSEL TUMORS : a- ANGIOBLASTOMA b- ANGIOMA

4- PITIUTARY & 3rd VENTRICLE TUMORS : a- CHROMOPHOBE ADENOMA b- CHROMOPHIL ADENOMA c- CRANIOPHARYNGIOMA d- PINEAL BODY TUMOR e- COLLOID CYST OF THE 3RD VENTRICLE 5- EIGTH NERVE TUMOR (ACCOUSTIC NEUROMA OR SCHWANNOMA)

EPIDEMIOLOGY ACCORDING TO AGE

SITES OF BRAIN TUMORS

I- SECONDARY (METASTATIC) II- PRIMARY : 1- GLIOMAS : a- ASTROCYTOMA (GRADE I-IV) b- MEDULLOBLASTOMA c- OLIGODENDROGLIOMA d- EPENDYMOMA 2- MENINGIOMAS 3- BLOOD VESSEL TUMORS : a- ANGIOBLASTOMA b- ANGIOMA

COMMON SITES OF CANCER METASTASIS

METASTATIC BRAIN TUMORS SAGGITAL MRI

I- SECONDARY (METASTATIC) II- PRIMARY : 1- GLIOMAS : a- ASTROCYTOMA (GRADE I-IV) b- MEDULLOBLASTOMA c- OLIGODENDROGLIOMA d- EPENDYMOMA 2- MENINGIOMAS 3- BLOOD VESSEL TUMORS : a- ANGIOBLASTOMA b- ANGIOMA

LOW GRADE GLIOMA (INTRAOPERATIVE)

LOW GRADE GLIOMA MRI’S

LOW GRADE GLIOMA AXIAL MRI

ANAPLASTIC ASTROCYTOMA AXIAL MRI’S

GLIOBLASTOMA MULTIFORMI

GM AXIAL MRI

I- SECONDARY (METASTATIC) II- PRIMARY : 1- GLIOMAS : a- ASTROCYTOMA (GRADE I-IV) b- MEDULLOBLASTOMA c- OLIGODENDROGLIOMA d- EPENDYMOMA 2- MENINGIOMAS 3- BLOOD VESSEL TUMORS : a- ANGIOBLASTOMA b- ANGIOMA

EPENDYMOMA CORONAL MRI

I- SECONDARY (METASTATIC) II- PRIMARY : 1- GLIOMAS : a- ASTROCYTOMA (GRADE I-IV) b- MEDULLOBLASTOMA c- OLIGODENDROGLIOMA d- EPENDYMOMA 2- MENINGIOMAS 3- BLOOD VESSEL TUMORS : a- ANGIOBLASTOMA b- ANGIOMA

OLIGODENDROGLIOMA AXIAL MRI

I- SECONDARY (METASTATIC) II- PRIMARY : 1- GLIOMAS : a- ASTROCYTOMA (GRADE I-IV) b- MEDULLOBLASTOMA c- OLIGODENDROGLIOMA d- EPENDYMOMA 2- MENINGIOMAS 3- BLOOD VESSEL TUMORS : a- ANGIOBLASTOMA b- ANGIOMA

MEDULLOBLASTOMA

MEDULLOBLASTOMA AXIAL MRI

CEREBELLUM AFTER SURGERY FOR MB

I- SECONDARY (METASTATIC) II- PRIMARY : 1- GLIOMAS : a- ASTROCYTOMA (GRADE I-IV) b- MEDULLOBLASTOMA c- OLIGODENDROGLIOMA d- EPENDYMOMA 2- MENINGIOMAS 3- BLOOD VESSEL TUMORS : a- ANGIOBLASTOMA b- ANGIOMA

MENINGIOMA

COMMON SITES OF MENINGIOMAS

OLFACTORY GROOVE MENINGIOMA MRI’S

I- SECONDARY (METASTATIC) II- PRIMARY : 1- GLIOMAS : a- ASTROCYTOMA (GRADE I-IV) b- MEDULLOBLASTOMA c- OLIGODENDROGLIOMA d- EPENDYMOMA 2- MENINGIOMAS 3- BLOOD VESSEL TUMORS : a- ANGIOBLASTOMA b- ANGIOMA

VENOUS ANGIOMAS

CEREBELLAR CAVERNOUS ANGIOMA AXIAL MRI

4- PITIUTARY & 3rd VENTRICLE TUMORS : a- CHROMOPHOBE ADENOMA b- CHROMOPHIL ADENOMA c- CRANIOPHARYNGIOMA d- PINEAL BODY TUMOR e- COLLOID CYST OF THE 3RD VENTRICLE 5- EIGTH NERVE TUMOR (ACCOUSTIC NEUROMA OR SCHWANNOMA)

PITIUTARY & PINEAL GLANDS

4- PITIUTARY & 3rd VENTRICLE TUMORS : a- CHROMOPHOBE ADENOMA b- CHROMOPHIL ADENOMA c- CRANIOPHARYNGIOMA d- PINEAL BODY TUMOR e- COLLOID CYST OF THE 3RD VENTRICLE 5- EIGTH NERVE TUMOR (ACCOUSTIC NEUROMA OR SCHWANNOMA)

PITIUTARY GLAND EFFECTS

PITIUTARY ADENOMA PRESENTATION

PITIUTARY ADENOMA

PITIUTARY TUMOR (AUTOPSY)

SKULL X-RAY FOR A PATIENT WITH PITIUTARY TUMOR (ERROSION OF SELLA TURSICA)

PITIUTARY TUMOR AXIAL & CORONAL MRI’S

PITIUTARY ADENOMA SAGGITAL MRI

4- PITIUTARY & 3rd VENTRICLE TUMORS : a- CHROMOPHOBE ADENOMA b- CHROMOPHIL ADENOMA c- CRANIOPHARYNGIOMA d- PINEAL BODY TUMOR e- COLLOID CYST OF THE 3RD VENTRICLE 5- EIGTH NERVE TUMOR (ACCOUSTIC NEUROMA OR SCHWANNOMA)

CRANIOPHARYNGIOMA

CRANIOPHARYNGIOMA (INTRA-OPERATIVE)

CRANIOPHARYNGIOMA CORONAL MRI

CRANIOPHARYNGIOMA CT-SCAN

4- PITIUTARY & 3rd VENTRICLE TUMORS : a- CHROMOPHOBE ADENOMA b- CHROMOPHIL ADENOMA c- CRANIOPHARYNGIOMA d- PINEAL BODY TUMOR e- COLLOID CYST OF THE 3RD VENTRICLE 5- EIGTH NERVE TUMOR (ACCOUSTIC NEUROMA OR SCHWANNOMA)

PINEAL GLAND

PINEAL BODY TUMOR

PINEAL TUMOR SAGGITAL MRI

4- PITIUTARY & 3rd VENTRICLE TUMORS : a- CHROMOPHOBE ADENOMA b- CHROMOPHIL ADENOMA c- CRANIOPHARYNGIOMA d- PINEAL BODY TUMOR e- COLLOID CYST OF THE 3RD VENTRICLE 5- EIGTH NERVE TUMOR (ACCOUSTIC NEUROMA OR SCHWANNOMA)

VENTRICULAR SYSTEM OF THE HUMAN BRAIN

COLLOID CYST OF 3rd VENTRICLE

C. CYST OF 3rd VENTRICLE T2 MRI

4- PITIUTARY & 3rd VENTRICLE TUMORS : a- CHROMOPHOBE ADENOMA b- CHROMOPHIL ADENOMA c- CRANIOPHARYNGIOMA d- PINEAL BODY TUMOR e- COLLOID CYST OF THE 3RD VENTRICLE 5- EIGTH NERVE TUMOR (ACCOUSTIC NEUROMA OR SCHWANNOMA)

SCHWANNOMA PATHOLOGY

VESTIBULAR SCHWANNOMA AXIAL MRI

MANAGEMENT

HOW TO DEAL WITH A BT PATIENT !!

SURGERY FOR BRAIN TUMORS

SURGICAL BRAIN SURFACE ANATOMY

BRAIN SURGERY

BIFRONTAL CRANIOTOMY

CRANIOTOMY FOR A BRAIN TUMOR

SITTING POSITION FOR POSTERIOR FOSSA SURGERIES

POSTERIOR FOSSA CRANIECTOMY

TRANSSPENOIDAL APPROACH FOR A PITIUTARY TUMOR

RADIOTHERAPY MACHINE

GAMMA KNIFE RADIOSURGERY

BENIGN INTRACRANIAL HYPERTENSION (BIH) -PSEUDOTUMOR CEREBRI-

AT HIGH RISK ?!

DEFINITION It is a syndrome that is defined by five criteria: 1-Increased intracranial pressure 2-Normal or small sized ventricles by neuroimaging 3-No evidence of an intracranial mass 4-Normal CSF composition 5-Papilledema

CLINICAL PRESENTATION OF BIH

DIAGNOSIS

CT-SCAN OF BIH (NORMAL CT)

TREATMENT 1- STEROIDS 2- ANALGESIA 3- DIURETICS 4- LUMBAR PUNCTURES 5 - LUMBO-PERITONEAL SHUNT

LUMBER PUNCTURE POSITION

LUMBER PUNCTURE TECHNIQUE

SITE OF LP

LP & CSF COLLECTION

LUMBO-PERITONEAL SHUNT

AND FINALLY ….

THERE SHOULD BE ALWAYS HOPE

THANK YOU