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