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PRIMARY INTRACRANIAL TUMORS is a topic covered in the Harrison's Manual of Medicine.

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Infiltrative tumors with a presumptive glial cell of origin. Most common primary intracranial neoplasm. Only known risk factors are ionizing radiation and uncommon hereditary syndromes (neurofibromatosis, tuberous sclerosis). Infiltration along white matter pathways often prevents total resection. Imaging studies (Fig. 189-1) fail to indicate full tumor extent. Grade I tumors (pilocytic astrocytomas) are the most common tumor of childhood, typically in the cerebellum; can be cured if completely resected. Grade II astrocytomas usually present with seizures in young adults; if feasible should be surgically resected. RT is helpful and chemotherapeutic agents such as temozolomide are increasingly used. Grade III (anaplastic astrocytoma) and grade IV (glioblastoma) astrocytomas are treated similarly with maximal safe surgical resection followed by RT with concomitant temozolomide, followed by 6–12 months of adjuvant temozolomide. Median survival in glioblastoma is 12–15 months. Glioblastomas invariably recur, and treatment options include reoperation, carmustine wafer implantation, and chemotherapeutic regimens including bevacizumab. The most important adverse prognostic factors in high-grade astrocytomas are older age, histologic features of glioblastoma, poor performance status, and unresectable tumor.

FIGURE 189-1

Postgadolinium T1 MRI of a large cystic left frontal glioblastoma.

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Loscalzo, Joseph, et al., editors. "PRIMARY INTRACRANIAL TUMORS." Harrison's Manual of Medicine, 19th ed., McGraw Hill Inc., 2017. harrisons.unboundmedicine.com/harrisons/view/Harrisons-Manual-of-Medicine/623477/all/PRIMARY_INTRACRANIAL_TUMORS.
PRIMARY INTRACRANIAL TUMORS. In: Loscalzo J, Jameson JL, Longo DL, et al, eds. Harrison's Manual of Medicine. 19th ed. McGraw Hill Inc.; 2017. https://harrisons.unboundmedicine.com/harrisons/view/Harrisons-Manual-of-Medicine/623477/all/PRIMARY_INTRACRANIAL_TUMORS. Accessed April 18, 2019.
PRIMARY INTRACRANIAL TUMORS. (2017). In Loscalzo, J., Jameson, J. L., Longo, D. L., Hauser, S. L., Fauci, A. S., & Kasper, D. L. (Eds.), Harrison's Manual of Medicine. Available from https://harrisons.unboundmedicine.com/harrisons/view/Harrisons-Manual-of-Medicine/623477/all/PRIMARY_INTRACRANIAL_TUMORS
PRIMARY INTRACRANIAL TUMORS [Internet]. In: Loscalzo J, Jameson JL, Longo DL, Hauser SL, Fauci AS, Kasper DL, editors. Harrison's Manual of Medicine. McGraw Hill Inc.; 2017. [cited 2019 April 18]. Available from: https://harrisons.unboundmedicine.com/harrisons/view/Harrisons-Manual-of-Medicine/623477/all/PRIMARY_INTRACRANIAL_TUMORS.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - PRIMARY INTRACRANIAL TUMORS ID - 623477 ED - Loscalzo,Joseph, ED - Jameson,J Larry, ED - Longo,Dan L, ED - Hauser,Stephen L, ED - Fauci,Anthony S, ED - Kasper,Dennis L, BT - Harrison's Manual of Medicine UR - https://harrisons.unboundmedicine.com/harrisons/view/Harrisons-Manual-of-Medicine/623477/all/PRIMARY_INTRACRANIAL_TUMORS PB - McGraw Hill Inc. ET - 19 DB - Harrison's Manual of Medicine DP - Unbound Medicine ER -