The Brain 3 Main Areas: Cerebrum, Cerebellum, Brain Stem. Scope. Cerebrum 3/22/2017. Disclaimer
|
|
- Bertram Quinn
- 6 years ago
- Views:
Transcription
1 Disclaimer Metro-Detroit Oncology Nursing Society PRACTICE PEARLS UPDATE IN CNS MALIGNANCY Gayle Groshko RN BSN OCN Beaumont Health Radiation Oncology Nurse Case Manager I have no conflicts of interest. Scope Cancer Stat Facts: Brain and other nervous system cancers (NCI SEER data) Estimate new cases in 2016: 23, 770 % of all new cancer cases: 1.4% Estimated deaths in 2016: 16, 050 % of all cancer deaths: 2.7% The Brain 3 Main Areas: Cerebrum, Cerebellum, Brain Stem Cerebrum Large, outer part of the brain 2 hemispheres Controls reasoning, thought, emotion, language Responsible for voluntary movement, talking and interpreting sensory information Symptoms of tumors of the cerebral hemisphere Seizure Trouble speaking Change in mood Change in personality Weakness, paralysis on one side of the body Change in senses, vision, hearing 1
2 Cerebellum Under the cerebrum, at the back of the brain Helps coordinate movement Symptoms of tumors of the cerebellum Problems with coordination Trouble walking Trouble with precise movements of arms, hands, legs, and feet Trouble swallowing Trouble synchronizing eye movements Changes in speech Brain Stem Lower part of the brain that connect to the spinal cord Contains bundles of nerves that carry the signals to control muscles and sensation Special centers in brain also control breathing and heart beat Most cranial nerves start in brain stem Symptoms of tumors of the brain stem Weakness Stiff muscles Trouble with sensation Trouble with facial or eye movement Double vision Loss of coordination Spinal Cord Long nerves that carry signals to/from brain to control muscles, sensation, bladder and bowel Symptoms of tumors of the spinal cord Numbness Weakness Paralysis Symptoms usually bilateral 2
3 Blood Brain Barrier Gliomas The inner lining of small blood vessels in the brain and spinal cord Create a selective barrier between blood and the tissues of the central nervous system Purpose is to maintain metabolic balance and prevent toxins from getting in to the brain General term to describe tumors that arise from the supportive tissues of the brain Glia helps keep neurons in place and functioning 3 types of glial cells that produce tumors: Astrocytes, Oligodendrocytes, Ependymal cells Astrocytoma Arise from astrocytes-star shaped cells that make up the glue-like supportive tissues of the brain Graded on a scale of I-IV Most astrocytomas in adults are high grade They can appear in the cerebrum, cerebellum, brain stem and spinal cord Symptoms include headache, seizures, memory loss, behavior changes More frequent in males; more frequent over age 45 Cause is unknown Treatment is surgery to remove as much tumor as possible and Radiation with or without chemotherapy; most likely Temozolomide Oligodendroglioma Oligodendrocytes make up the supportive tissue of the brain Can arise anywhere in the cerebral hemispheres but most often occur in the frontal and temporal lobes Often contain calcifications, areas of hemorrhage and cysts They can be slow growing Most common symptoms are seizures, headaches, personality changes, difficulty with short term memory Cause is unknown but chromosomal abnormalities are being investigated Treatment is surgical resection followed by chemotherapy + Radiation Ependymoma Ependymal cells line the ventricles and the center of the spinal cord Symptoms depend on location and size Nausea, vomiting and headache most common Cause is unknown Treatment is surgical resection CNS Lymphoma Arise in the cells of the lymphatic system, usually B- lymphocytes Occur most often in the cerebral hemispheres May involve cerebral spinal fluid, the eyes or the spinal cord Most often presents as personality or behavior changes, confusion, headache, nausea, vomiting, drowsiness, vision change Can occur in healthy as well as immunocompromised Steroids given for cerebral edema Treated with radiation and chemotherapy 3
4 Meningioma Pituitary Tumors Represent about 1/3 of all brain tumors Often benign Arise from the coverings of the brain and spinal cord Because they grow inward they can put pressure on the brain and spine. They can also grow outward causing the skull to thicken Because of slow growth they can reach large size before causing symptoms Incidence increases with age Between 40% to 80% contain an abnormal chromosome 22 They have been found to have extra copies of platelet derived growth factor (PDGFR) and epidermal growth factor (EGFR) receptors Previous Radiation to the head and neck or neurofibromatosis II may be risk factors Surgery and Radiation are the common treatments Tumors arising from the pituitary gland Adenomas are slow growing and benign Carcinomas are rare Account for about 10% of brain tumors Most grow in the front 2/3 of the gland Tumors are classified as secreting or non-secreting depending on hormones produced Symptoms include headache, visual impairment, behavior changes. Visual field testing performed. Hormones most commonly affected are growth hormone (regulates body height and structure), prolactin (controls lactation), sex hormones, thyroid hormones, adrenal gland hormones, vasopressin Treatment is surgery and radiation, medication Post radiation patients monitored for gland function and may need replacement thyroid hormones, testosterone for men, estrogen for women, adrenal hormones, growth hormones. Medicines Prolactin: Bromocriptine (Parlodel), Cabergoline (Destinex) Growth Hormone: Octreotide (Sandostatin) Pegvisomant (Somavert) Thyroid Stimulating Hormone: Octreotide (Sandostatin) Acoustic Neuroma Non-cancerous tumor Develops on 8 th cranial nerve which connects the inner ear to the brain Early symptoms are subtle hearing loss Tinnitus Feeling of fullness in the ear Balance disturbance Vertigo Facial numbness, tingling Facial weakness Some are associated with neurofibromatosis type II Treatment is surgery and radiation. They type of surgery may result in permanent hearing loss Brain Metastasis Spread of cancer from a tumor outside the brain Lung cancers account for the highest number of brain metastasis Other frequent cancers include melanoma, breast, colon, and renal cell If the met is solitary may be resected, or Gamma Knife, for multiple mets treatement is whole brain radiation Leptomeningeal Metastasis Spread of tumor cells to meninges Occurs in about 5% of cancer patients Usually fatal Untreated, median survival 4-6 weeks Treated, median survival 2-3 months Pain and seizures most common presentation Other symptoms include headache, ataxia, memory loss, sensory abnormalities, lethargy If there is cranial nerve involvement patient may have impaired vision, diplopia, hearing loss, cranial nerve palsy Diagnosis is made with imaging and lumbar puncture Positive cytology found in 50%-70% of patients. Elevated CSF pressure and elevated CSF protein also common Treatment is radiation to bulky sites and intrathecal chemotherapy 4
5 Diagnosis History and physical, performance status Symptom profile, onset and severity Neurologic exam: reflexes, muscle strength, sensation, vision, eye movements, coordination and balance, cognition Cognitive Assessment Brain and Spine Tumor Diagnosis Consultation with Neurosurgery, Neurology, Endocrinology, Medical Oncology, ENT, Radiation Oncology MRI with and without contrast the gold standard CT lacks MRI s resolution; used in patient who cannot have MRI MR Spectroscopy: assess metabolites with in tumors and normal tissue; useful in differentiating tumor from radiation necrosis. MR Perfusion: measures cerebral blood volume in tumors. May be useful in differentiating grade of tumor and determining tumor vs. radiation necrosis Brain PET scanning: Assesses metabolism within tumor and normal tissue Principles of Brain Tumor Surgery Gross total resection when possible Minimal surgical morbidity Adequate specimen to determine diagnosis and molecular markers Chemotherapy implants if indicated; Gliadel wafer (carmustine)-placed in resection cavity, wafer degrades releasing the drug. (Used in high-grade glioma) Biopsy/resection Diagnosis Removal of tumor Craniotomy 5
6 Nursing Management Assist in assessment Coordinate between disciplines, assist with scheduling Medication management; steroids, anticonvulsants, endocrine therapies Pre-op teaching Post-op incision care, treatment planning, MRI Nursing Care Following Craniotomy Immediate post-op phase q30-60 minute neuro checks: level of consciousness, weakness, mobility, aphasia, cognition, visual changes, pupils, nausea and vomiting Keep head of bed elevated to reduce pressure; unless infratentorial approach, then bed flat Monitor dressing and drains; normal drainage in hemovac or jackson-pratt about ml Administer medications Continued assessment for signs of increased intracranial pressure: headache, seizure, nausea and vomiting, unusual pupil size and reactivity Pathology Tissue diagnosis Histologic sub groups, molecular hallmarks WHO Meningioma Pathology Radiation Atoms form the basic building blocks of all matter Atoms consist of a nucleus: made of positively charged protons and neutrally charged neutrons; and an outer cloud of electron which are negatively charged The positive charge of a single proton is equal to the negative charge of a single electron; so equal at net zero If an atom loses or gains an electron it becomes an ion and carries a charge Ionizing radiation caused by unstable atoms giving off energy In ionizing radiation the target is cellular DNA Ionizing Radiation Caused by unstable atoms giving off energy to reach a stable state Target is cellular DNA 6
7 The Atom Principles of Brain and Spinal Cord Tumor Radiation Radiotherapy is the most effective nonsurgical treatment for brain tumors Tumor volumes are defined using pre-and postoperative imaging and simulation films Clinical target volume and surrounding 1-2 cm margin is drawn Doses are measured in Gy. Radiation-Gliomas Clinical target volume plus 1-2 cm margin delineated on treatment planning Low grade (I/II) treated daily, Monday-Friday, total dose Gy, Gy fractions. SRS not indicated in low grade tumors High grade (III/IV) treated daily, Monday-Friday, total dose 60 Gy in 2.0 Gy fractions. Lower dose can be given in grade III tumors Elderly, poor-performance status patients generally treated at a hypofractionated accelerated course; example 34 Gy in 10 fractions-50 Gy in 20 fractions. Radiation-CNS Lymphoma Low-dose whole brain RT following complete response to chemotheray. Doses usually limited to 23.4 Gy. For less than complete response to chemotherapy; whole brain RT plus limited field RT to gross disease If patient does not receive chemotherapy, whole brain RT to dose of Gy with boost to gross disease, total RT dose is 45 GY Radiation-Spinal Tumors Primary tumor doses are Gy, given in 1.8 Gy fractions. Spine metastasis: dose depends on performance status, spine stability, primary tumor histology. Some cases can be single fraction Stereotactic body radiotherapy. Radiation Treatment Planning Simulation: planning session for radiation therapy. Patient education as to potential treatment side effects: fatigue, headache, weakness, vision changes, nausea and vomiting (generally due to cerebral edema; may exacerbate presenting symptoms) Scalp and hair care: mild shampoo like baby shampoo, no styling products. Wash face with mild soap live Dove, Basis, Neutrogena. No lotions on radiated skin 4 hours prior to treatment. Immobilization device. If patient is claustrophobic, may require premedication with xanax. 7
8 Aquaplast mask Radiation Therapy Side Effects Headaches Hair loss Nausea Vomiting Extreme fatigue Hearing loss Skin/scalp dryness, itching, sunburn like reaction Trouble with memory and speech Approaches to Neurocognitive Toxicity Hippocampus Block Increased focus on focal therapy; surgery, stereotactic radiotherapy Neurocognitive decline due to microvacular changes, neuroglial loss and damage to the hippocampus Hippocampus located in temporal lobes; responsible for learning and memory. New radiation techniques include treatment plans that block the hippocampus Whole Brain Neurotoxicity Long term decrease in cognition, memory Trial of Memantine published in Neuro Oncology 2013 Oct; 15(10): (RTOG 0614) Brain mets receiving whole brain RT, 508 eligible patients. Patients randomized to Memantine 20mg/day vs. placebo, within 3 days of RT and for 24 weeks. There was less decline in recall in the Memantine arm (not statistically significant, only 149 analyzable patients at 24 weeks). The Memantine arm had better cognitive function over time, reduced rate in decline in memory, executive function, processing speed than the placebo arm. Memantine (Namenda) RTOG 0614 dosing schedule Week 1 5mg AM Week 2 5mg AM 5mg PM Week 2 10mg AM 5 mg PM Week mg AM 10mg PM Generally well tolerated, rare side effects: dizziness, headache, constipation, pain, shortness of breath, high blood pressure, coughing, nervousness, changes in behavior, tremor. 8
9 Systemic Therapy for CNS Tumor Therapy selection and dosing based on tumor type, patient performance status. NCCN Guidelines NCCN Guidelines NCCN Guidelines Optune Treatment for Glioblastoma Multiforme (GBM) following maximal debulking, RT and concomitant chemotherapy Treatment for recurrent GBM Wearable device, transducer arrays applied to scalp and connected to device and battery When turned on creates low-intensity electric fields called TTFields TTFields travel in waves; designed to interfere with cell division Worn in combination with Temozolomide (Temodar) Clinical trials have shown device to improve progression-free survival from Temodar alone (7.2 months vs. 4 months) and median survival (20.5 months vs months) Device should be attached/worn for at least 18 hours a day Optune 9
10 References NCCN Guidelines Version Why and how to spare the hippocampus during brain radiotherapy: the developing role of hippocampal avoidance in cranial radiotherapy Neuro Oncol Oct; 15(10) Memantine for the prevention of cognitive dysfunction in patients receiving wholebrain radiotherapy: a randomized, double-blind, placebo-controlled trial. Brown PD, Pugh S, Laak NN, Watkins-Bruner D, RTOG Ca: A cancer journal for clinicians. January/February 2017 Leptomeningeal Metastatis: What Nurses Need to Know. Schweisguth, D Bursine 2015 Dec: 45(12):
MALIGNANT GLIOMAS: TREATMENT AND CHALLENGES
MALIGNANT GLIOMAS: TREATMENT AND CHALLENGES DISCLOSURE No conflicts of interest to disclose Patricia Bruns APRN, CNS Givens Brain Tumor Center Abbott Northwestern Hospital October 12, 2018 OBJECTIVES THEN
More informationBrain tumors: tumor types
Brain tumors: tumor types Tumor types There are more than 120 types of brain tumors. Today, most medical institutions use the World Health Organization (WHO) classification system to identify brain tumors.
More informationBrain and Spine Tumors
Brain and Spine Tumors Andrew J. Fabiano, MD FAANS Associate Professor of Neurosurgery Roswell Park Cancer Institute SUNY at Buffalo School of Medicine Brain Tumors Brain Tumor Basics Types of Tumors Cases
More informationNeurosurgery Review. Mudit Sharma, MD May 16 th, 2008
Neurosurgery Review Mudit Sharma, MD May 16 th, 2008 Dr. Mudit Sharma, Neurosurgeon Manassas, Fredericksburg, Virginia http://www.virginiaspinespecialists.com Phone: 1-855-SPINE FIX (774-6334) Fundamentals
More informationNON MALIGNANT BRAIN TUMOURS Facilitator. Ros Taylor Advanced Neurosurgical Nurse Practitioner Southmead Hospital Bristol
NON MALIGNANT BRAIN TUMOURS Facilitator Ros Taylor Advanced Neurosurgical Nurse Practitioner Southmead Hospital Bristol Neurosurgery What will be covered? Meningioma Vestibular schwannoma (acoustic neuroma)
More informationWhat are brain and spinal cord tumours? Contents
13 11 20 Information and support What are brain and spinal cord tumours? Contents The brain and spinal cord Brain function What is a brain or spinal cord tumour? What types of tumours are there? How common
More informationBrain Tumors. Andrew J. Fabiano, MD FAANS. Associate Professor of Neurosurgery Roswell Park Cancer Institute SUNY at Buffalo School of Medicine
Brain Tumors Andrew J. Fabiano, MD FAANS Associate Professor of Neurosurgery Roswell Park Cancer Institute SUNY at Buffalo School of Medicine Brain Tumors Brain Tumor Basics Types of Tumors Cases Brain
More informationAMERICAN BRAIN TUMOR ASSOCIATION. Oligodendroglioma and Oligoastrocytoma
AMERICAN BRAIN TUMOR ASSOCIATION Oligodendroglioma and Oligoastrocytoma ACKNOWLEDGEMENTS ABOUT THE AMERICAN BRAIN TUMOR ASSOCIATION Founded in 1973, the American Brain Tumor Association (ABTA) was the
More informationAdult Brain and Spinal Cord Tumors
Adult Brain and Spinal Cord Tumors An adult central nervous system (CNS) tumor is a disease in which abnormal cells form in the tissues of the brain and or the spinal cord. Major Parts of the Brain Anatomy
More informationOligodendrogliomas & Oligoastrocytomas
Oligodendrogliomas & Oligoastrocytomas ABOUT THE AMERICAN BRAIN TUMOR ASSOCIATION Founded in 1973, the American Brain Tumor Association (ABTA) was the first national nonprofit organization dedicated solely
More informationSTEREOTACTIC RADIATION THERAPY. Monique Blanchard ANUM Radiation Oncology Epworth HealthCare
STEREOTACTIC RADIATION THERAPY Monique Blanchard ANUM Radiation Oncology Epworth HealthCare Overview Stereotactic radiation therapy at Epworth Healthcare What is stereotactic radiation therapy? Delivery
More informationAMERICAN BRAIN TUMOR ASSOCIATION. Oligodendroglioma and Oligoastrocytoma
AMERICAN BRAIN TUMOR ASSOCIATION Oligodendroglioma and Oligoastrocytoma ACKNOWLEDGEMENTS ABOUT THE AMERICAN BRAIN TUMOR ASSOCIATION Founded in 1973, the American Brain Tumor Association (ABTA) was the
More informationLearn about Leptomeningeal Disease
Learn about Leptomeningeal Disease Information for patients and caregivers Princess Margaret Read this resource to learn: What is leptomeningeal disease What are the symptoms of leptomeningeal disease
More informationDr Eddie Mee. Neurosurgeon Auckland City Hospital, Ascot Integrated Hospital, MercyAscot Hospitals, Auckland
Dr Eddie Mee Neurosurgeon Auckland City Hospital, Ascot Integrated Hospital, MercyAscot Hospitals, Auckland 16:30-17:25 WS #48: Current Management of Brain Bleeds and Tumours 17:35-18:30 WS #58: Current
More informationPRINCESS MARGARET CANCER CENTRE CLINICAL PRACTICE GUIDELINES
PRINCESS MARGARET CANCER CENTRE CLINICAL PRACTICE GUIDELINES CENTRAL NERVOUS SYSTEM BRAIN METASTASES CNS Site Group Brain Metastases Author: Dr. Norm Laperriere Date: February 20, 2018 1. INTRODUCTION
More informationUnderstand Your Disease: Brain Metastases
Understand Your Disease: Brain Metastases Princess Margaret For patients and families coping with brain metastases Read this resource to know: What brain metastases are Common symptoms of brain metastases
More informationWhat is Brain Cancer? What is the brain?
What is Brain Cancer? The brain and spinal column make up the central nervous system (CNS), where all vital functions of the body are controlled. When tumors arise in the central nervous system, they are
More informationBrain Tumor Treatment
Scan for mobile link. Brain Tumor Treatment Brain Tumors Overview A brain tumor is a group of abnormal cells that grows in or around the brain. Tumors can directly destroy healthy brain cells. They can
More informationAdult Central Nervous System Tumors Treatment (PDQ )
1 di 20 28/06/2016 11.18 NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health. PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute
More informationIt s s Always Something!
It s s Always Something! New Approaches in Brain Tumor Treatment Virginia Stark-Vance, M.D. When Something Is a Brain Tumor Brain tumors aren t rare: there are over 100,000/yr Most originate as other cancers
More informationDosimetry, see MAGIC; Polymer gel dosimetry. Fiducial tracking, see CyberKnife radiosurgery
Subject Index Acoustic neuroma, neurofibromatosis type 2 complications 103, 105 hearing outcomes 103, 105 outcome measures 101 patient selection 105 study design 101 tumor control 101 105 treatment options
More informationMeningioma tumor. Meningiomas are named according to their location (Fig. 1) and cause various symptoms: > 1
Meningioma tumor Overview A meningioma is a type of tumor that grows from the protective membranes, called meninges, which surround the brain and spinal cord. Most meningiomas are benign (not cancer) and
More informationPediatric Brain Tumors: Updates in Treatment and Care
Pediatric Brain Tumors: Updates in Treatment and Care Writer Classroom Rishi R. Lulla, MD MS Objectives Introduce the common pediatric brain tumors Discuss current treatment strategies for pediatric brain
More informationPRINCESS MARGARET CANCER CENTRE CLINICAL PRACTICE GUIDELINES
PRINCESS MARGARET CANCER CENTRE CLINICAL PRACTICE GUIDELINES CENTRAL NERVOUS SYSTEM EPENDYMOMA Last Revision Date July 2015 1 CNS Site Group Ependymoma Author: Dr. Norm Laperriere 1. INTRODUCTION 3 2.
More informationTumors of the Nervous System
Tumors of the Nervous System Peter Canoll MD. PhD. What I want to cover What are the most common types of brain tumors? Who gets them? How do they present? What do they look like? How do they behave? 1
More informationBrain and Central Nervous System Cancers
Brain and Central Nervous System Cancers NICE guidance link: https://www.nice.org.uk/guidance/ta121 Clinical presentation of brain tumours History and Examination Consider immediate referral Management
More informationBiocomputer Wired for Action MWABBYH CTBIR LOBES
Biocomputer Wired for Action MWABBYH CTBIR LOBES 100 100 100 100 100 200 200 200 200 200 300 300 300 300 300 400 400 400 400 400 500 500 500 500 500 Biocomputer Wired for Action MWABBYH CTBIR LOBES 100
More informationTania Kaprealian, M.D. Assistant Professor UCLA Department of Radiation Oncology August 22, 2015
Tania Kaprealian, M.D. Assistant Professor UCLA Department of Radiation Oncology August 22, 2015 Most common brain tumor, affecting 8.5-15% of cancer patients. Treatment options: Whole brain radiation
More informationGeneral: Brain tumors are lesions that have mass effect distorting the normal tissue and often result in increased intracranial pressure.
1 Lecture Objectives Know the histologic features of the most common tumors of the CNS. Know the differences in behavior of the different tumor types. Be aware of the treatment modalities in the various
More informationLearning About Optune. Understanding Optune. A guide for patients and their caregivers. Actor portrayals
Learning About Optune Understanding Optune A guide for patients and their caregivers Actor portrayals Indications For Use Optune is intended as a treatment for adult patients (22 years of age or older)
More informationBasic Brain Structure
The Human Brain Basic Brain Structure Composed of 100 billion cells Makes up 2% of bodies weight Contains 15% of bodies blood supply Uses 20% of bodies oxygen and glucose Brain Protection Surrounded by
More informationUpdate on Pediatric Brain Tumors
Update on Pediatric Brain Tumors David I. Sandberg, M.D. Director of Pediatric Neurosurgery & Associate Professor Dr. Marnie Rose Professorship in Pediatric Neurosurgery Pre-talk Questions for Audience
More informationNANOS Patient Brochure
NANOS Patient Brochure Pituitary Tumor Copyright 2015. North American Neuro-Ophthalmology Society. All rights reserved. These brochures are produced and made available as is without warranty and for informational
More informationCNS TUMORS. D r. Ali Eltayb ( U. of Omdurman. I ). M. Path (U. of Alexandria)
CNS TUMORS D r. Ali Eltayb ( U. of Omdurman. I ). M. Path (U. of Alexandria) CNS TUMORS The annual incidence of intracranial tumors of the CNS ISmore than intraspinal tumors May be Primary or Secondary
More informationKnow about brain metastases and treatment
Know about brain metastases and treatment Princess Margaret For patients and families living with brain metastases Read this resource to learn: What are brain metastases 2 How can the Brain Metastases
More informationOtolaryngologist s Perspective of Stereotactic Radiosurgery
Otolaryngologist s Perspective of Stereotactic Radiosurgery Douglas E. Mattox, M.D. 25 th Alexandria International Combined ORL Conference April 18-20, 2007 Acoustic Neuroma Benign tumor of the schwann
More informationThierry M. Muanza, MSc, MD, FRCPC,, McGill University Segal Cancer Centre, Jewish General Hospital Montreal, QC, Canada
Thierry M. Muanza, MSc, MD, FRCPC,, McGill University Segal Cancer Centre, Jewish General Hospital Montreal, QC, Canada Déclarations Aucun conflit d intérêt Objectifs d apprentissage Évolution de la radiothérapie
More informationImaging for suspected glioma
Imaging for suspected glioma 1.1.1 Offer standard structural MRI (defined as T2 weighted, FLAIR, DWI series and T1 pre- and post-contrast volume) as the initial diagnostic test for suspected glioma, unless
More informationNeuro-oncology Update Andrew Kokkino, MD Medical Director, The Neurosciences Institute at Sacred Heart at Riverbend May 20, 2013
Neuro-oncology Update 2013 Andrew Kokkino, MD Medical Director, The Neurosciences Institute at Sacred Heart at Riverbend May 20, 2013 Case 1 58 year old man with recent facial droop and HA s Thin, cachectic
More informationTumors of the Central Nervous System
Tumors of the Central Nervous System 1 Financial Disclosures I have NO SIGNIFICANT FINANCIAL, GENERAL, OR OBLIGATION INTERESTS TO REPORT Introduction General: Brain tumors are lesions that have mass effect
More informationFunctional Organization of the Central Nervous System
Functional Organization of the Central Nervous System Hierarchical orgnization CNS consists of the brain and the spinal cord The brain analyzes and interprets the information Response messages are
More informationCapt. Nazim ATA Aerospace Medicine Specialist Turkish Air Force AAMIMO 2013
F-15 Pilot with ACOUSTIC NEUROMA Capt. Nazim ATA Aerospace Medicine Specialist Turkish Air Force AAMIMO 2013 Disclosure Information 84 th Annual AsMA Scientific Meeting Nazim ATA I have no financial relationships
More informationThe Role of Radiation Therapy in the Treatment of Brain Metastases. Matthew Cavey, M.D.
The Role of Radiation Therapy in the Treatment of Brain Metastases Matthew Cavey, M.D. Objectives Provide information about the prospective trials that are driving the treatment of patients with brain
More information1. Processes nutrients and provides energy for the neuron to function; contains the cell's nucleus; also called the soma.
1. Base of brainstem; controls heartbeat and breathing 2. tissue destruction; a brain lesion is a naturally or experimentally caused destruction of brain tissue 3. A thick band of axons that connects the
More informationTHE EFFECTIVE OF BRAIN CANCER AND XAY BETWEEN THEORY AND IMPLEMENTATION. Mustafa Rashid Issa
THE EFFECTIVE OF BRAIN CANCER AND XAY BETWEEN THEORY AND IMPLEMENTATION Mustafa Rashid Issa ABSTRACT: Illustrate malignant tumors that form either in the brain or in the nerves originating in the brain.
More informationCancer Survivorship NEURO-ONCOLOGY PATIENT SURVIVORSHIP PLAN. Resources and Tools for the Multidisciplinary Team
NEURO-ONCOLOGY PATIENT SURVIVORSHIP PLAN Cancer Survivorship Resources and Tools for the Multidisciplinary Team Your survivorship care plan is a summary of your tumor treatments and recommendations for
More informationBiology 3201 Nervous System #2- Anatomy. Components of a Nervous System
Biology 3201 Nervous System #2- Anatomy Components of a Nervous System In any nervous system, there are 4 main components: (1) sensors: gather information from the external environment (sense organs) (2)
More informationManage Brain Metastases: A Guide through Treatment and Beyond
Manage Brain Metastases: A Guide through Treatment and Beyond Princess Margaret For patients and families living with brain metastases In this resource you will learn: Who is part of your care team What
More informationPeter Canoll MD. PhD.
Tumors of the Nervous System Peter Canoll MD. PhD. What I want to cover What are the most common types of brain tumors? Who gets them? How do they ypresent? What do they look like? How do they behave?
More informationChapter 5 Section 3.1
Radiology Chapter 5 Section 3.1 Issue Date: March 27, 1991 Authority: 32 CFR 199.4(b)(2), (b)(2)(x), (c)(2)(viii), and (g)(15) 1.0 CPT 1 PROCEDURE CODES 37243, 61793, 61795, 77261-77421, 77427-77799, 0073T
More informationRadiotherapy and Brain Metastases. Dr. K Van Beek Radiation-Oncologist BSMO annual Meeting Diegem
Radiotherapy and Brain Metastases Dr. K Van Beek Radiation-Oncologist BSMO annual Meeting Diegem 24-02-2017 Possible strategies Watchful waiting Surgery Postop RT to resection cavity or WBRT postop SRS
More informationSelected radiosurgery cases from the Rotating Gamma Institute Debrecen, Hungary
Selected radiosurgery cases from the Rotating Gamma Institute Debrecen, Hungary László Bognár M.D., Ph.D., József G. Dobai M.D., Gábor Csiky and Imre Fedorcsák M.D., Ph.D. Department of Neurosurgery, Medical
More informationFirst glance at. Optune TM
For newly diagnosed or recurrent GBM First glance at Optune TM Actor portrayals Indications for Use Optune is intended as a treatment for adult patients (22 years of age or older) with histologically-confirmed
More informationX-Plain Brain Cancer Reference Summary
X-Plain Brain Cancer Reference Summary Introduction Brain tumors are not rare. About 20,000 Americans are diagnosed with brain cancer or related cancer of the nervous system. This reference summary will
More information3/15/17. Outline. Nervous System - PNS and CNS. Two Parts of the Nervous System
Nervous System - PNS and CNS Bio 105 Outline I. Central Nervous System vs Peripheral Nervous System II. Peripheral Nervous System A. Autonomic Nervous Systems B. Somatic Nervous Systems III. Autonomic
More informationNervous System - PNS and CNS. Bio 105
Nervous System - PNS and CNS Bio 105 Outline I. Central Nervous System vs Peripheral Nervous System II. Peripheral Nervous System A. Autonomic Nervous Systems B. Somatic Nervous Systems III. Autonomic
More informationChapter 6. Body and Behavior
Chapter 6 Body and Behavior Section 1 The Nervous System: The Basic Structure How the nervous system works Central nervous system (CNS)- the brain and spinal cord Spinal cord- nerves that run up and down
More informationLOW GRADE ASTROCYTOMAS
LOW GRADE ASTROCYTOMAS This article was provided to us by David Schiff, MD, Associate Professor of Neurology, Neurosurgery, and Medicine at University of Virginia, Charlottesville. We appreciate his generous
More informationNeurosurgical Management of Brain Tumours. Nicholas Little Neurosurgeon RNSH
Neurosurgical Management of Brain Tumours Nicholas Little Neurosurgeon RNSH General Most common tumours are metastatic 10x more common than primary Incidence of primary neoplasms is 20 per 100000 per year
More informationPRINCESS MARGARET CANCER CENTRE CLINICAL PRACTICE GUIDELINES
PRINCESS MARGARET CANCER CENTRE CLINICAL PRACTICE GUIDELINES CENTRAL NERVOUS SYSTEM MENINGIOMA CNS Site Group Meningioma Author: Dr. Norm Laperriere Date: February 20, 2018 1. INTRODUCTION 3 2. PREVENTION
More informationBrain Tumors. What is a brain tumor?
Scan for mobile link. Brain Tumors A brain tumor is a collection of abnormal cells that grows in or around the brain. It poses a risk to the healthy brain by either invading or destroying normal brain
More informationNivolumab. Other Names: Opdivo. About this Drug. Possible Side Effects (More Common) Warnings and Precautions
Nivolumab Other Names: Opdivo About this Drug Nivolumab is used to treat cancer. It is given in the vein (IV). Possible Side Effects (More Common) Bone marrow depression. This is a decrease in the number
More informationFOCUSING ON TUMORS. Ependymoma
FOCUSING ON TUMORS Ependymoma A Word About ABTA Founded in 1973, the not-for-profit American Brain Tumor Association has a proud history of funding research, providing patient services, and educating people
More informationStereotactic Radiosurgery and Stereotactic Body Radiation Therapy
Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy Policy Number: Original Effective Date: MM.05.008 05/12/1999 Line(s) of Business: Current Effective Date: HMO; PPO; QUEST Integration 11/20/2015
More informationCNS SESSION 3/8/ th Multidisciplinary Management of Cancers: A Case based Approach
CNS SESSION Chair: Ruben Fragoso, MD/PhD UC Davis Fellow: Michael Cardenas, MD UC Davis Panel: Gordon Li, MD Stanford Seema Nagpal, MD Stanford Jennie Taylor, MD UCSF HPI: 46 yo right handed woman who
More informationSURGICAL MANAGEMENT OF BRAIN TUMORS
SURGICAL MANAGEMENT OF BRAIN TUMORS LIGIA TATARANU, MD, Ph D NEUROSURGICAL CLINIC, BAGDASAR ARSENI CLINICAL HOSPITAL BUCHAREST, ROMANIA SURGICAL INDICATIONS CONFIRMING HISTOLOGIC DIAGNOSIS REDUCING TUMOR
More information(7) VITAL SIGNS (8) LEVEL OF CONSCIOUSNESS (9) MENTAL STATUS (10) SPEECH (11) VISION (12) FUNDUS (PAPILLEDEMA)
Radiation Therapy Oncology Group Phase II CNS Lymphoma Follow-Up Form RTOG Study No. 1114 Case # Amended Data Yes INSTRUCTIONS: Submit this form as indicated in the protocol. All dates need to be recorded
More informationStereotactic Radiosurgery and Stereotactic Body Radiation Therapy
Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy Policy Number: Original Effective Date: MM.05.008 05/12/1999 Line(s) of Business: Current Effective Date: HMO; PPO; QUEST Integration 04/01/2017
More informationmeninges Outermost layer of the meninge dura mater arachnoid mater pia mater membranes located between bone and soft tissue of the nervous system
membranes located between bone and soft tissue of the nervous system meninges Outermost layer of the meninge dura mater middle layer of the meninges, contains no blood vessels arachnoid mater Innermost
More informationOptimal Management of Isolated HER2+ve Brain Metastases
Optimal Management of Isolated HER2+ve Brain Metastases Eliot Sims November 2013 Background Her2+ve patients 15% of all breast cancer Even with adjuvant trastuzumab 10-15% relapse Trastuzumab does not
More informationfmri (functional MRI)
Lesion fmri (functional MRI) Electroencephalogram (EEG) Brainstem CT (computed tomography) Scan Medulla PET (positron emission tomography) Scan Reticular Formation MRI (magnetic resonance imaging) Thalamus
More informationVascular Disorders. Nervous System Disorders (Part B-1) Module 8 -Chapter 14. Cerebrovascular disease S/S 1/9/2013
Nervous System Disorders (Part B-1) Module 8 -Chapter 14 Overview ACUTE NEUROLOGIC DISORDERS Vascular Disorders Infections/Inflammation/Toxins Metabolic, Endocrinologic, Nutritional, Toxic Neoplastic Traumatic
More informationProblems of Neurological Function. Unit 10
Problems of Neurological Function Unit 10 Independent Student Review Brain Anatomy and physiology of cerebral hemispheres, diencephalon, brain stem, and cerebellum Meninges, ventricles, flow of CSF Blood
More informationFACT SHEET. About Optune
About Optune Optune is the Tumor Treating Fields (TTFields) delivery system that is approved by the United States (US) Food and Drug Administration (FDA) for the treatment of adult patients with glioblastoma.
More informationSymptoms of a brain tumour in adults
Symptoms of a brain tumour in adults A tumour is an abnormal growth caused by cells dividing in an uncontrolled manner. Approximately 9,300 people are diagnosed with a primary brain tumour each year. (Primary
More informationBiology 3201 Unit 1: Maintaining Dynamic Equilibrium II
Biology 3201 Unit 1: Maintaining Dynamic Equilibrium II Ch. 12 The Nervous System (Introduction and Anatomy) The Nervous System - Introduction Cells, tissues, organs and organ systems must maintain a biological
More informationMetastatic Brain Tumors
Metastatic Brain Tumors F O C U S I N G O N T U M O R S American Brain Tumor Association A Word About ABTA Founded in 1973, the American Brain Tumor Association was the first national, nonprofit organization
More informationChallenging Paediatric Brain Tumours. ASP Belfast March 2017 Dr Jane Pears Consultant Paediatric Oncologist, Dublin
Challenging Paediatric Brain Tumours ASP Belfast March 2017 Dr Jane Pears Consultant Paediatric Oncologist, Dublin Overview (i) Paediatric malignancy (ii) Central nervous system tumours (iii) Diffuse Intrinsic
More informationCentral nervous system
Central nervous system By Dr. Mohsen Dashti Clinical Medicine & Pathology 316 7 th Lecture Lecture outline Review of structure & function. Symptoms, signs & tests. Specific diseases. Review of structure
More information14 - Central Nervous System. The Brain Taft College Human Physiology
14 - Central Nervous System The Brain Taft College Human Physiology Development of the Brain The brain begins as a simple tube, a neural tube. The tube or chamber (ventricle) is filled with cerebrospinal
More informationBio11: The Nervous System. Body control systems. The human brain. The human brain. The Cerebrum. What parts of your brain are you using right now?
Bio11: The Nervous System Body control systems Nervous system Quick Sends message directly to target organ Endocrine system Sends a hormone as a messenger to the target organ Can target several organs
More informationIntroduction to Neurosurgical Subspecialties:
Introduction to Neurosurgical Subspecialties: Tumor and Skull Base Neurosurgery Brian L. Hoh, MD 1 and Gregory J. Zipfel, MD 2 1 University of Florida, 2 Washington University Tumor / Skull Base Neurosurgery
More informationBrain Tumors: an Introduction
1 2 Brain Tumors: an Introduction Overview A tumor is an abnormal growth of cells. Brain tumors are named after the cell type from which they grow some are benign, others malignant.. They may be primary
More informationQ&A. Fabulous Prizes. Collecting Cancer Data:CNS 2/7/12. NAACCR Webinar Series Collecting Cancer Data Central Nervous System
Collecting Cancer Data Central Nervous System NAACCR 2012 2013 Webinar Series 2/7/2013 Q&A Please submit all questions concerning webinar content through the Q&A panel. Reminder: If you have participants
More informationStereotactic Radiosurgery. Extracranial Stereotactic Radiosurgery. Linear accelerators. Basic technique. Indications of SRS
Stereotactic Radiosurgery Extracranial Stereotactic Radiosurgery Annette Quinn, MSN, RN Program Manager, University of Pittsburgh Medical Center Using stereotactic techniques, give a lethal dose of ionizing
More informationThe Role of Radiotherapy in Metastatic Breast Cancer. Shilpen Patel MD, FACRO Associate Professor Departments of Radiation Oncology and Global Health
The Role of Radiotherapy in Metastatic Breast Cancer Shilpen Patel MD, FACRO Associate Professor Departments of Radiation Oncology and Global Health Indications for Palliative Pain Control Radiation Bone
More informationChildhood Central Nervous System Atypical Teratoid/Rhabdoid Tumor Treatment (PDQ )
1 di 10 27/06/2016 08.16 NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health. PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute
More informationThe Nervous System and the Endocrine System
The Nervous System and the Endocrine System Neurons: The Building Blocks of the Nervous System Nervous System The electrochemical communication system of the body Sends messages from the brain to the
More informationRadiotherapy for lymphoma
Radiotherapy for lymphoma The name of your consultant is: The radiographer who explained the treatment to you is: You can contact us on: What is radiotherapy? Radiotherapy treats cancer by using high energy
More informationThe Nervous System. Biological School. Neuroanatomy. How does a Neuron fire? Acetylcholine (ACH) TYPES OF NEUROTRANSMITTERS
Biological School The Nervous System It is all about the body!!!! It starts with an individual nerve cell called a NEURON. Synapse Neuroanatomy Neurotransmitters (chemicals held in terminal buttons that
More informationFROM DISCOVERY TO RECOVERY A Guide for Adult Brain Tumor Patients & Caregivers Contents Diagnosis What is a brain tumor?...3 What is the difference be
PENN NEUROSCIENCES FROM DISCOVERY TO RECOVERY A Guide for Adult Brain Tumor Patients & Caregivers Have you or a loved one been diagnosed with a brain tumor? If so, you likely have many questions about
More informationStereotactic Radiosurgery and Stereotactic Body Radiation Therapy
Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy Policy Number: Original Effective Date: MM.05.008 05/12/1999 Line(s) of Business: Current Effective Date: HMO; PPO; QUEST Integration 04/01/2015
More informationNeurotransmitter: dopamine. Physiology of additive drugs. Dopamine and reward. Neurotransmitter: dopamine
Physiology of additive drugs Cocaine, methamphetamine, marijuana, and opiates influence the neurotransmitter dopamine. Neurotransmitter: dopamine Dopamine - a neurotransmitter associated with several functions,
More informationAMERICAN BRAIN TUMOR ASSOCIATION. Proton Therapy
AMERICAN BRAIN TUMOR ASSOCIATION Proton Therapy ACKNOWLEDGEMENTS ABOUT THE AMERICAN BRAIN TUMOR ASSOCIATION Founded in 1973, the American Brain Tumor Association (ABTA) was the first national nonprofit
More informationAlleinige Radiochirurgie und alleinige Systemtherapie zwei «extreme» Entwicklungen in der Behandlung von Hirnmetastasen?
Department of Radiation Oncology Chairman: Prof. Dr. Matthias Guckenberger Alleinige Radiochirurgie und alleinige Systemtherapie zwei «extreme» Entwicklungen in der Behandlung von Hirnmetastasen? Matthias
More informationThere are several types of epilepsy. Each of them have different causes, symptoms and treatment.
1 EPILEPSY Epilepsy is a group of neurological diseases where the nerve cell activity in the brain is disrupted, causing seizures of unusual sensations, behavior and sometimes loss of consciousness. Epileptic
More informationCilengitide (Impetreve) for glioblastoma multiforme. February 2012
Cilengitide (Impetreve) for glioblastoma multiforme February 2012 This technology summary is based on information available at the time of research and a limited literature search. It is not intended to
More informationThe Nervous System: Central Nervous System
The Nervous System: Central Nervous System I. Anatomy of the nervous system A. The CNS & the body by: 1. monitoring of the body 2. & information between parts of the body 3. acting as a to gather, store,
More informationProtons for Head and Neck Cancer. William M Mendenhall, M.D.
Protons for Head and Neck Cancer William M Mendenhall, M.D. Protons for Head and Neck Cancer Potential Advantages: Reduce late complications via more conformal dose distributions Likely to be the major
More informationModules 4 & 6. The Biology of Mind
Modules 4 & 6 The Biology of Mind 1 Neuron - 100 Billion - Communication System Glial cells Cell body (nucleus) Dendrites Axon Axon Terminals (terminal buttons) Synaptic cleft 3 4 Communication Within
More information