Nervous system structures control the operation of all organic systems and are divided into two parts: peripheral and central. The central part is the cerebrospinal and spinal structures, the peripheral consists of nerves.
Nerve tissue can be affected by neoplastic diseases, among which neurinoma is quite common.
Concept of the disease
Neurinoma is a benign tumor formation that forms in the Schwann cell structures of peripheral, cranial and spinal nerves.
In fact, neurinoma is a neoplasm in the cellular structures that cover the neural canals. These are capsular-like lobular or rounded tumors, which most often occur in the radicular part of the auditory nerve, progressing in the auditory and facial nerves.
Much less often, such formations affect the ocular or maxillary nerves.
Neurinomas are often called schwannoma or neurilemoma.
The incidence of neuritis is approximately 9-14% of the total number of intracranial lesions. As for the spinal schwannoma, it occupies one fifth of the total number of vertebral tumors.
The most frequent localization of neurinoma is the auditory or pre-vertebral-cochlear nerve, then the trigeminal nerve. In fact, neurinoma can form on the shells of any nerves.
Varieties of
Schwannomas are classified as benign and slow-growing formations, however, in exceptional cases they are capable of malignancy. Such formations are diverse.
- Neurinoma Morton is a benign schwannoma, localized in the nerve region on the sole of the foot. It occurs mainly between the third and fourth toes, rarely between the third and the second. Usually it has a one-sided character, although there were cases when the tumor struck both feet simultaneously.
- Schwannoma of the spine - usually located in the thoracic vertebral column or in the neck and represents a tumor formation on the spinal nerve roots. Among all primary cerebrospinal formations, this tumor is considered to be the most common. Such formations can germinate through the intervertebral foramen, which is characteristic of cervical neurinomas. Against the backdrop of the vertebral schnannom, bone deformations developed through spondylographic diagnosis develop.
- Neurinoma of the brain - the tumor is characterized by slow growth, delimiting the surrounding structures with a capsule-like shell.
- Schwannoma of the auditory nerve( or acoustic neuroma) - can be found in patients of any age and sex, is predominantly one-sided and is characterized by slow growth rates.
In addition, patients often have tumors of the trigeminal, pre-collar nerve, mediastinum or tibia, optic, peripheral nerve, etc.
Causes of the pathology of
The reasons for the development of neurin are not definitively defined, as is the case with most nervous systems.
Specialists unequivocally assert that the processes of shvannom formation begin as a result of the growth of Schwann cells under the influence of gene mutations in chromosomes, or rather, in chromosome 22.
The causes of these mutations are also unknown, but one can say for sure which factors can provoke them:
- Hereditary predisposition to pathology;
- Long-term effects of chemicals and reagents;
- Intensive radiation exposure in early childhood;
- The presence of benign tumors of a different localization and character;
- The presence of neurofibromatosis in the patient or in one of his parents.
Heredity is considered to be the most important provoking factor of schwannoma, which confirms the association of the tumor with neurofibromatosis, which is a hereditary pathology and develops as a result of gene mutations of 22 chromosomes.
Symptoms of neurinoma
There are no specific signs that distinguish neurin from other tumors.
If the tumor differs intracranial localization, then there is a craniocerebral syndrome, with peripheral lesions there are problems with the sensitivity of the limbs, and the spinal schwannomas differ in the presence of symptoms of spinal cord injury.
- Neurinoma of the spine
Symptomatic of such formations is reduced mainly to the pain syndrome, spinal lesions of the transverse type and vegetative disorders.
In the defeat of the forebrain, paralysis and paresis of muscle tissue takes place in the innervation region, and with the schwannoma of the posterior nerve roots, sensitivity is disturbed, there is a sensation of creeping and numbness.
Initially, the symptomatology is transient, however, with the growth of neurinoma, the severity of the clinic becomes more vivid and permanent. The pain is usually intense and prone to strengthening in a supine position.
With lesions of the thoracic or cervical nerve roots, the pain is localized between the scapulas in the chest or in the neck. With the lumbar localization of schwannoma, the pain syndrome will be concentrated in the lumbar region and in the extremities.
- Morton neurinoma
A similar tumor is located between the toes. Initially, the patient experiences a feeling of numbness, discomfort and soreness after wearing high-heeled shoes or a narrow form, after long walks or jogs.
With a similar neurinoma, the pain syndrome in the foot is typically increased, if you squeeze it with your hands. Some patients had a sensation of the presence of a foreign object in the foot.
Soreness intensifies undulating and also stops. But further development leads to constant pulsating pains that arise regardless of loads and shoes.
- Schwannoma of the brain
Gonovnozgovye neurinomas include lesions of the leading, trigeminal and facial nerves. Such tumors appear in the face, tenderness, and numbness.
When involved in the tumor process of the facial nerve, there are taste disorders, problems with salivation, etc. Similar symptoms occur when other facial nerves are affected.
- Trigeminal nerve tumor
Trigeminal neurinoma( V) of the nerve is classified on a tumor of 1 branch, root or gasser node. The symptomatology of such formations differs according to their location.
So, the tumors of the gasser's node are accompanied by weakness of the masticatory muscles, paresthesias, soreness. The tumor in the first branch of the nerve causes doubling and exophthalmos.
Radicular schwannomas can provoke ataxia and damage the auditory or facial nerve, causing flavors, pain on the face, sensations of numbness, chills, or cold. There may be smells that are not there, and there is a taste of any food, although the patient did not eat anything.
- Neurinoma of the auditory or pre-cochlear nerve - vestibular schwannoma
Similar formations grow very slowly, so the onset of their development occurs latent. It occurs mainly in the elderly and in middle-aged patients. It is usually located on one side, although cases of bilateral lesions are known.
Usually, the vestibular schwannoma is characterized by extraneous noise in the ears( from the side of the tumor), the patient's hearing functions decrease intensively, until their complete loss, Disturbances are disturbed by imbalance and motor coordination.
Especially dangerous is considered a large or giant neurinoma of the pre-cochlear nerve, because it squeezes the brain stem at the site of vital centers like respiratory or vasomotor, etc.
Such compression can lead to impairment of respiratory and cardiovascular activity, which can lead to death.
- Pelvic neurinoma
A similar schwannoma affects a nerve node located in the area of the sacrum and coccyx, which is called the ponytail.
For the neurinoma of such a localization, there is a characteristic pain in the lumbosacral region, so this formation is often confused with radiculitis.
Pain symptomatology can be of a different nature - shingles, lumbago, etc.
Symptomatically, the pony tail schnannoma is manifested by acute pain syndrome in the affected area, extending to the lower extremities and buttocks. If the patient lies down, the soreness becomes more pronounced.
First the pain appears on one side of the body, but then it gradually spreads to the other.
- Schwannoma mediastinum
Neurogenic mediastinal tumors are considered the most common among all formations of the posterior mediastinum. Out of all formations of similar origin, approximately 70% are benign.
They are manifested by chest pains, breathing disorders, night hyperdense and apnea. They are detected by means of classical radiography.
- Peripheral nerves
Peripheral schwannomas grow rather slowly and are mostly surface-like. Externally, this formation looks like a single tumor of small size and rounded shape that grows along the hone of the nerve fiber.
For such formations, tend to have soreness and sensitivity disorders, but if the disease continues to progress, then muscle paresis is observed.
- Neurinoma of the lung
Pulmonary neurin accounts for about 2% of the total number of benign tumors of this organ. Typically, these neurinomas are of a single character, although in isolated cases they may accompany a systemic pathology like Recklinghausen syndrome.
Usually pulmonary schwannomas have extrabronchial localization, but can also be located endobronchially. Extrabronchial tumors often grow latent, causing rare symptoms like dyspnea and cough, minor hyperthermia, mild soreness in the lesion.
If schwannoma develops intrabronchially, then the tumor process is accompanied by signs of secondary inflammation, bronchial obstruction, etc.
- Cervical neurinoma
Similar formulations account for about 60% of tumors of peripheral nerves. Such formations are most typical for patients of mature age and manifest symptoms such as hypersensitivity and slow growth rate, oval shape, pulsation and soreness.
If a similar neurinoma penetrates into the plexus of the shoulder, then there is shooting pain. There may be paralysis of the muscular tissues of the tongue, larynx, etc.
Neurinoma and pregnancy
Neurinoma is not considered a definitive contraindication to pregnancy, however, sometimes the tumor begins to grow intensively with the carrying of the child.
Therefore, doctors usually recommend removal of the tumor, and a year after the treatment can be planned pregnancy.
Diagnosis of
The diagnosis of neuritis is usually based on the results obtained from procedures like:
- A comprehensive neurological examination that identifies diplopia, paresis, impaired swallowing reflex, sensitive disorders, gait or balance disorders;
- Magnetic Resonance Imaging - A similar study can visualize schwannomas at the earliest stages of their formation;
- Computer tomography is carried out with the help of a contrast medium, which allows detecting tumors of a very small size, starting at 1.5 cm;
- Ultrasonic diagnosis, which refers to safe and sufficiently informative methods, visualizing soft tissue changes in education;
- Radiographic diagnosis, which reveals bone changes that occur against the background of tumor growth;
- Audiometry, which determines the presence of auditory disorders with the auditory nerve schwanoma;
- A biopsy study that relates to invasive diagnostics and involves the production of a piece of a tumor for the purpose of further histological examination.
Treatment of Schwannoma
The choice of therapeutic technique is carried out individually according to the type and location of the tumor.
The usual treatment for neurinoma is surgical intervention, which is shown when:
- Rapidly increasing the tumor;
- Progression of education after a radiosurgical operation;
- Increase in symptoms or the emergence of new manifestations.
But the operations also have their own specific contraindications like the patient's serious condition, the presence of cardiovascular pathologies or the elderly patient( after 65).
If the tumor is localized on the spine, then operations usually take place without any difficulties, because such formations usually have a dense capsule and do not germinate through the brain envelope.
If the formation is tightly fused with the fibers of the nerves, then the tumor is removed with its partial preservation. Of course, this approach is dangerous relapse, however, it prevents neurological complications associated with radical surgery.
Sometimes treatment is carried out using stereotaxic surgery. Such therapy consists in irradiating the tumor without damaging the surrounding healthy tissues. It has minimal side effects, but in the future it often turns into tumor recurrence.
Consequences after operation
Since there is always a risk of nerve damage in any tumor location, the most common consequence of surgical intervention is the impairment of motor function and sensitivity.
If a schwannoma affects the auditory nerve, the possibility of hearing loss, which arises not so much from surgical intervention, as against the background of tumor pressure on the surrounding structures, is not ruled out.
Also a frequent consequence is the violation of the muscles responsible for the facial movements, and the paresis of the nerve on the face.
Treatment with folk remedies
The use of folk methods of treatment in neurinoma contributes to the relief of some symptoms, however, it is impossible to cure education in this way.
Schwannoma can not self-resolve only under the influence of folk methods. And delaying a visit to a specialist can aggravate the situation and bring the pathology to a more serious condition.
Forecast
In general, the predictions for neurinomas are favorable. Since the tumor grows slowly, it can be long terminated with conservative methods.
If a successful operation is performed to the patient, it guarantees its complete cure without complications and negative consequences.
This video shows the removal of the neurinoma of the trigeminal nerve: