Other Brain Tumors

Brain Tumors

This section will not review ALL types of brain tumors, and instead will provide enough information to identify a tumor that is not a meningioma, which has it's own dedicated page due to its highly identifiable qualities, and other highly characteristic brain pathologies covered in this wiki. Brain tumors may present with symptoms such as seizure, vision changes, circling, head pressing, dull or obtunded affect, ataxia, or behavior changes. The symptoms will depend on severity and location. Primary brain tumors arise from brain tissue, such as supporting glial cells such as astrocytes, oligodendrocytes, ependymal cells, and may include:

Ependymoma

Glioma

Oligodendroglioma

There are some. albeit variable, broadly common qualities or primary brain tumors that can separate them from other pathologies in this wiki:

More commonly focal; only one spot

Intra axial; inside the brain tissue

May be poorly circumscribed; less defined or blurry edges

May have cystic or hemorrhagic components

Edema

Mass effect

May be common in one area of the brain

May or may not display contrast enhancement

Heterogenous; different signal intensities across the tumor over different weightings

Necrotic core

Primary Brain Tumors on MRI

There is no one best pulse sequences to identify a primary brain tumor, the complete brain MRI protocol is required to characterize the tumor. Below is a sample brain protocol and which information each sequence may provide in characterizing a tumor:

Sag T2: Identify tonsillar herniation

Ax T2: Identify edema and fluid components

Ax T2 FLAIR: Identify edema, check is fluid is nulled

Ax T2* GRE: Identify hemorrhage

Ax DWI: Confirm vasogenic edema, rule out ischemia, identify abscess, diffusion properties of the tumor

Ax T1: Confirm if hemorrhage is subacute, compare to post gad imaging

Post Gad T1: Check for presence and pattern of any enhancement; gad enhancement means blood brain barrier is broken down or tumor is vascularized

Examples of Primary Brain Tumors