Hemangioblastoma of the cerebellum, brain and spinal cord: symptoms, treatment, prognosis

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There are many tumors consisting of vascular elements. To such formations include hemangioblastomas.

The concept of the disease

So, a hemangioblastoma is considered to be a tumor, formed from the blood vessels of the brain. Most often, such formations are detected in the tissues of the cerebellum, but may occur in the spinal cord or cerebrospinal stem.

In about 10 out of 100 cases, the tumor acts as a sign of a hereditary pathology of Hippel-Lindau or phacomatosis.

For this disease, the typically active formation of multiple intraorganic tumors. Hemangioblastomas of similar etiology are most characteristic for patients of 20-30 years of age.

Causes of

Many factors contribute to tumor development, but most often they are hereditary.

For example, the above Hippel-Lindau disease, which is accompanied by hemangioblastomas, has a hereditary etiology.

Provoke tumor and carcinogenic factors such as:

• Ionizing radiation;
• of oncogenic viruses such as herpes, retroviruses and adenoviruses;
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• Insolation measures;
• Carcinogens like benzene, various kinds of resins, vinyl chloride, asbestos or phenol formaldehyde, etc.

Classification

Hemangioblastomas are divided into 2 large categories: microscopic and macroscopic. Microscopic tumors are classified into:

1. Chistocellular - on the anomalous vessels, the yolk-cell mass builds up;
2. Transitional - half a tumor consists of stromal cells, and half - of a network of capillaries;
3. Juvenile - formation is tightly closed with each other capillaries with thin walls.

The category of macroscopic formations is classified into:

1. Cystic - is a cyst containing a solid component on its smooth walls;
2. Solid or soft tissue hemangioblastoma - this formation looks like a nodule of tumor cells placed in a soft capsule of dark red color. Such hemangioblastomas are considered the most common, occupying approximately 65% ​​of the total number of formations;
3. Mixed tumors - externally they represent a solid formation, but the internal structure is an accumulation of cystic components.

Symptoms of the hemangioblastoma of the brain and spinal cord

The clinical picture of such tumors depends on their specific location, which can be inside the brain tissue( rarely), in the oblong( ≈2%) or spinal cord( ≈4-12%) and the cerebellum( about 85%).

For a clearer picture of the pathology, all the symptoms are divided into several groups: distant, cerebellar and cerebral.

To remote manifestations include:

• Sensitivity disorders;
• Convulsions;
• Paralyzes;
• Disorders of urinary and intestinal activity;
• Other disorders such as nystagmus, tremor, muscle hypotension, etc.

  At the initial stage of hemangioblastoma development, the cerebellum is localized on the side where clinical disturbances occur, however, the cerebellum formations are prone to rapid proliferation,in the process of which a bilateral education is being formed.

  When the hemangioblastoma of the cerebellum of the brain is started, asthenia, neuroses, neurasthenia, deafness with impaired consciousness and other mental disorders develop.

  To cerebral manifestations include a pronounced hydrocephalus, the patient's condition is regarded as deteriorated, taking medication does not give an analgesic effect. The patient complains of constant headaches and dizziness, nauseous-vomiting syndrome. With ophthalmoscopy, violations in the activity of the optic nerves are revealed.

  Diagnosis

  Diagnosis of a similar disease using research like:

  • Magnetic resonance imaging;
  • Computed tomography;
  • Cerebral angiography;
  • EEG;
  • Echo;
  • Spinal angiography;
  • REG, etc.

  During the ophthalmological consultation, stagnant visually-nerve discs are found that cause suspicions of the presence of volumetric education in the brain.

  Treatment of hemangioblastoma

  Hemangioblastomas have non-invasive benign character, therefore, for a successful cure, traditional surgical excision is sufficient. Such formations are usually characterized by a clear delineation from neighboring tissues, but there is no specific delimiting capsule.

  To get to the formation, the patient is usually given craniotomy, which involves the removal of the bone site at the back of the head and the resection of the cervical vertebral arch. After the manipulations, the tumor itself is removed. If it has a cystic character, aspiration of intra-cystic contents is additionally carried out.

  If the cerebellum wedges into the nape of the occiput and presses the cerebral column, then an emergency removal of the formation takes place. Prior to the operation, the patient is reduced by ICP by puncture of the lateral ventricle.

  If hemangioblastoma can not be completely removed and it is impossible to provide a full flow of liquor from the cranial cavity, shunting is performed.

  Forecast

  Statistically, favorable predictions occur in the majority of clinical cases( approximately 85%), but only if removal of the hemangioblastoma was complete.

  Otherwise, soon the tumor will revive again. Prognosis worsens if the tumor develops against the backdrop of the Hippel-Lindau pathology.

  Video shows the removal of hemangioblastoma of the brain: