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 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 tumor Infratentorial lesions Supratentorial lesions Frontal lobe lesions Temporal lobe lesions Parietal lobe lesions Occipital lobe lesions

Frontal lobetumor Frontal lobe tumor Central groove

glioma Temporal lobetumor Temporal lobe tumor

Gliomameningoma Metastatic tumor Parietal lobetumor Parietal lobe tumor Parietal lobe

Contralateral visual field deficits Occipital lobetumor Occipital lobe tumor

Radiology 1. CT scan 2. MRI 3. MRA

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. 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 Tumors The 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 Tumors The 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 Tumors 1. Astrocytoma 2. Oligodendroglioma 3. Ependymoma 4. Primitive Neuroectodermal Tumors 5. Hemangioblastoma 6. Primary Central Nervous System Lymphoma Intra-axial Brain Tumors 1. Astrocytoma 2. Oligodendroglioma 3. Ependymoma 4. Primitive Neuroectodermal Tumors 5. Hemangioblastoma 6. Primary Central Nervous System Lymphoma

Astrocytoma

脑干肿瘤 MRI 片 ( 失状扫描 )

脑干肿瘤 MRI 片（平扫）

四脑室肿瘤 MRI 片（平扫）

四脑室肿瘤（冠状扫描）

Extra-axial Brain Tumors 1. Meningiomas 2. Schwannomas 3. Pituitary Adenomas

Meningioma 左侧小脑幕 Meningioma （冠状位）

嗅沟脑膜瘤

Meningioma 左桥小脑角 Meningioma （平扫）

Pituitary Adenomas

Secondary Brain Tumors Metastatic Brain Tumors

Metastatic Brain Tumors

Intraspinal Tumors Intraspinal tumors are commonly divided into three groups: 1. extradural 2. intradural extramedullary 3. intramedullary

Summary Primary Brain Tumors Intra-axial Brain Tumors Extra-axial Brain Tumors Secondary Brain Tumors Summary Primary Brain Tumors Intra-axial Brain Tumors Extra-axial Brain Tumors Secondary Brain Tumors

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Notice Content: Clinical practice Time: 2:00pm this Thursday Address: Department of Neurosurgery, the 8th floor, No.5 Building ， No.1,hospital. Notice Content: Clinical practice Time: 2:00pm this Thursday Address: Department of Neurosurgery, the 8th floor, No.5 Building ， No.1,hospital.