wk tutesmor

30
Sutis Nasia, dr, SpS

description

tes

Transcript of wk tutesmor

Sutis Nasia, dr, SpS

PENDAHULUAN

Tumor primer (70-80%):

Otak dan selaput otak

Insidensi 6: 100.000

Tumor sekunder (20-30%):

metastase paru, tiroid, payudara, prostat, cervix, dll

Lokasi Tumor

Supratentorial

Infratentorial

Dewasa 80% supratentorial : 20% Infratentorial

Anak 40% supratentorial : 60% Infratentorial

KLASIFIKASI TUMOR :

Klasifikasi Samuels (1986) berdasarkan atas lokasi tumor,

1. Tumor supratentorial

a. Hemisfer otak :

Glioma : - glioblastoma multiforme

- astrositoma

- oligodendroglioma

Meningioma

Tumor metastasis

b. Tumor struktur median :

Adenoma hipofisis

Tumor glandula pinealis

Kraniofaringioma

2. Tumor infratentorial

Dewasa :

a. Schwannoma akustikus (neurilemmoma, neurinoma akustik)

b. Tumor metastasis

c. Meningioma

d. Hemangioblastoma (Von Hippel – Lindau)

Anak-anak :

a. Astrositoma serebelaris

b. Medulloblastoma

c. Ependimoma

d. Glioma batang otak

3. Tumor medulla spinalis

a. Ekstradural : Metastasis, Dermoid

b. Intradural :

Ekstramedular :

Meningioma

Neurofibroma (30 %)

Angioma

Intramedular : Ependimoma (60 % tumor MS)

Most common brain tumors in adults Meningiomas

Glioblastomas

Pituitary adenomas

Metastatic tumors

Most common brain tumors in children Astrocytomas

Medullobastomas

ETIOLOGI :

:

1. Bawaan (meningioma, astrositoma dan neurofibroma)

2. Bangunan embrional yang tersisa (kraniofaringioma, teratoma

intrakranial, kordoma,.

3. Radiasi dengan dosis terapeutik dapat merangsang sel-sel

mesenkhimal. Beberapa laporan bahwa radiasi berperan

timbulnya meningioma.

4. Virus (virus Epstein Barr) disangka berperan dalam

genesisnya “Burkitt’s lymphoma” juga karsinoma anaplastik

nasofaring.

5. Zat-zat karsinogenik “methylcholanthrone” dan “nitro-ethyl-

urea” dapat menyebabkan tumor otak primer.

CAUSES

Only unequivocal risk factor for glial and meningeal neoplasms is ionizing radiation.

Alledged to increase the risk of brain tumors

Use of cellular telephones

Exposure to high-tension wires

Use of hair dyes

Head trauma

Dietary exposure to n-nitrosurea compounds

DIAGNOSIS

Based on classic symptoms (headache) and findings on neurologic exam that are substantiated by specific diagnostic imaging.

TREATMENT Surgery is part of the initial management of virtually

all brain tumors.

Establishes diagnosis

Relieves symptoms

Radiation therapy is useful in the management of malignant brain tumors.

Meningioma

CT-scan Meningioma

Edema cerebri

Meningioma

operasi

radiosurgery

METASTASIS KE OTAK

SISTEM LIQUOR CEREBRI SPINAL LCS diproduksi 500 cc / hari

Plexus choroidalis di ventrikel lateralis-III-IV

Hidrosefalus

Peningkatan cairan sekresi

Hambatan absorbsi

TerapiAtasi Etiologi : SAH, Meningitis, Tumor, dll

Drainage :

-eksternal : infeksi/septik

-Ventriculo-peritoneal shunt: steril

VP-shunt

TRAUMA CAPITIS

SUBDURAL HEMATOMA

EPIDURAL HEMATOMA

BICONCAF