Medulloblastoma
Medulloblastoma
Medulloblastoma
DifferentialDiagnoses
Astrocytoma
Ependymoma
Meningitis, Aseptic
Meningitis, Bacterial
Laboratory Studies
The routine pretreatment laboratory evaluation for medulloblastoma
includes CBC count, electrolytes, liver, and renal function tests.
Baseline thyroid function studies and viral titers are also
recommended.
maging Studies
CT scanning
A CT scan of the head with and without contrast has more than 95%
sensitivity for the detection of brain tumors.
On CT scans, prominent hydrocephalus and a solid, homogeneous,
isodense to hyperdense, contrast-enhancing, midline cerebellar mass
are characteristic of (although not diagnostic of) medulloblastoma.
MRI
Head and spinal MRI with and without gadolinium should be performed
in all patients with CT or clinical findings consistent with
medulloblastoma.
Other midline posterior fossa tumors, such as cerebellar astrocytoma
and ependymoma, may have a similar appearance on CT.
MRI can be useful in such instances by better demonstrating the
anatomic origin and extent of tumor (see the image below).
Inline figure
Patient Education
Patients and family members should be instructed about the care of
the central venous catheter.
Patients should be instructed about protection against infection and
what to do should infection be suspected during therapy.
For excellent patient education resources, visit eMedicineHealth's
Cancer Center. Also, see eMedicineHealth's patient education article
Brain Cancer.
Complications
Complications include the following:
Obstructive hydrocephaly
Neurologic impairment
1 Holland et al conducted a study to identify factors associated
with academic difficulties in survivors of pediatric
medulloblastoma.[10] The study focused on school competence
and fluent academic performance. Thirty-six patients (aged 718 years) were recruited for the study. Participants completed
a neuropsychological screening battery that included selected
Woodcock-Johnson III Tests of Achievement subtests. Parents
completed the Child Behavior Checklist. Basic academic skill
development was found to be broadly average, in contrast to
fluent academic performance, which was significantly worse
than average. The investigators concluded that school
competence may have utility in estimating levels of
educational success in survivors of pediatric medulloblastoma
and that academic difficulties in these patients may be better
assessed through measures of deficits in fluent academic
performance rather than academic skills.[10]
Radiation-induced effects
1 Neurocognitive and endocrinologic dysfunction
2 Mineralizing microangiopathy with ischemia or infarct
3 Secondary CNS and thyroid malignancies
http://reference.medscape.com/article/987886-followup#a2649
nursing care plan
Brain Tumor
A brain tumor, or tumour, is an intracranial solid neoplasm, a tumor
(defined as an abnormal growth of cells) within the brain or the central
spinal canal.
A brain tumor begins when normal cells in the brain change and grow
uncontrollably, forming a mass. A tumor can be benign (noncancerous)
or malignant (cancerous). In general, primary CNS tumors do not
spread outside of the CNS. Malignant brain tumors are further
classified using a grade: low, intermediate, or high.
Brain tumors can occur at any age. The exact cause of brain tumors is
not clear.
There most common type of primary brain tumors among adults are
astrocytoma, meningioma, and oligodendroglioma.
The most common type of primary brain tumors in children are
medulloblastoma, grade I or II astrocytoma, ependymoma, and brain
stem glioma.
The most common symptoms of brain tumors include headaches;
numbness or tingling in the arms or legs; seizures, memory problems;
mood and personality changes; balance and walking problems; nausea
and vomiting; changes in speech, vision, or hearing.
Assessment for Brain Tumor (Intracranial Tumor)
Focal neurological disorders. In the frontal lobe, occurred
personality disorders, affective disorders, the motor system
dysfunction, seizures, aphasia. Precentral gyrus can be found on
Jacksonian seizures. In the occipital lobe, visual disturbances,
and headache. Temporal lobe can occur auditory hallucinations,
visual or gustatory and psychomotor seizures, aphasia. In the
parietal lobe can be found the inability to distinguish left right,
sensory deficit (contralateral).
Increased ICT: lethargy, decreased HR, decreased level of
consciousness, papilledema, projectile vomiting, seizures,
changes in breathing patterns, changes in vital signs.
Mental. Personality changes, depression, decreased memory and
ability to make decisions.
Pituitary dysfunction. Cushings syndrome, acromegaly,
giantisme, hypopituitarism.