Neoplasms of the brain and spinal cord are considered the most dangerous diseases, because due to the peculiarities of their location, some types of treatment can not be used. The group of these pathologies includes glioma - a tumor from glial cells that perform an auxiliary function in the structure of the nervous system.
Gliomas can be malignant, and in this case, the growth of education occurs quickly enough. Gliomas of a benign species grow slowly, the diagnosis is made after a thorough examination and histological analysis.
The concept of
Glioma is diagnosed in 60 patients out of 100 patients with different neoplasms in the brain. Its name was given to this tumor due to the fact that it begins to grow from glial cells.
Glia is one of the structures of the nervous system, in the formation of which cells of different shapes participate. Glial cells fill the spaces between the capillaries and neurons, and with normal development of the brain make up 10% of its volume.
With age, there is a decrease in neurons and an increase in the volume of glia. Glial cells surround the nerve trunks, perform a protective function and help in the transfer of impulses.
Glioma usually has the form of a node with fuzzy boundaries, its color is pink, grayish, in rare cases, dark red. The form of the tumor is spindle-shaped, rounded, the size is from 2 mm, in some people tumors are detected that reach the size of a large apple.
Glioma is characterized by infiltrative growth, which does not allow us to clearly establish the separation boundary between pathological and healthy tissues.
Symptoms of gliomas are similar to neurological diseases and it is often because of this that incorrect treatment is performed at the initial stages. The new growth that affects glial cells is revealed in people of different ages. But still, gliomas are most often found in young people and in children.
Classification of
In practical medicine, several classifications of gliomas are used.
- Oligodendroglioma.
- To the ephemeral.
- To the astrocytoma. Astrocytes are considered the main element of glia, and therefore the tumors of their cells are detected in most cases.
There are also new types of mixed species that develop from different glial cells.
The following classification is used by WHO and it subdivides gliomas into four degrees of malignancy:
- The first degree includes benign gliomas and slow flow. Examples are pleomorphic xanthostrocytoma, juvenile astrocytoma, giant cell astrocytoma.
- The second degree of malignancy is exhibited if glioma has one sign of cancer degeneration. And most often it is cellular atypia.
- The third degree of malignancy is exhibited if two of the three signs of the cancer process are detected during the examination: nuclear atypia, endothelial microprofile and mitosis.
- At the fourth degree of glioma, in addition to three or four signs of the disease, foci of tissue with necrosis are also found.
Two groups of gliomas are distinguished at the site of localization:
- Supratentorial ones are found in the cerebral hemispheres. In these places there are no ways of outflow of cerebrospinal fluid and venous blood, and due to this glioma of such localization, initially lead to focal symptoms. Hypertensive syndrome occurs with tumors of large sizes.
- Subtentorial neoplasms are tumors located in the posterior cranial fossa. With this localization, the pathways of the CSF are rapidly squeezed, and this affects the early development of intracranial hypertension.
Glioma of the optic nerve
This tumor develops from glial elements surrounding the optic nerve. Characterized by a gradual development and the absence of severe symptoms at the very beginning of the disease.
Glioma of the optic nerve is the cause of vision loss, exophthalmos, that is, protrusion of the eyeball and nerve atrophy.
Glioma can be localized in any part of the optic nerve. If the neoplasm is within the orbit, then it is intra-orbital, and ophthalmologists are treating this glioma. Glioma, localized where the optic nerve passes in the skull, is designated as intracranial, and its treatment is handled by neurosurgeons.
Glioma of the optic nerve refers to diseases that occur primarily in children. Pathology is characterized by a benign course, but with late circulation, nerve atrophy leads to blindness.
Diffuse brain glioma of the brainstem
Localization of brain stem glioma is the place of connection of the spinal cord and brain. In this part of the body, the centers of the nervous system are concentrated, responsible for breathing, palpitation, movements, and a number of the most important functions for humans.
Lesions of this area lead to malfunction of the vestibular apparatus, speech and auditory dysfunction, difficulty in swallowing food, severe headaches, drowsiness and a number of severe symptoms.
Gliomas of the brain stem are mainly detected in children from three to 10 years. Symptoms can build up both slowly and literally in a matter of weeks.
In the latter case, it may be a rapid growth of the tumor, which is an unfavorable sign. In adults, tumors of glial tissue of the brain stem are very rarely detected.
Chiasmic tumor
This type of neoplasm is located in the part of the brain where the visual intersection is located.
Most often, glioma of the chiasma is an astrocytoma and can be found not only in children, but also in people older than 20 years. In patients with this type of glioma, a concomitant disease is found in 33% of cases - Recklinghausen's neurofibromatosis.
Low-grade formation of
Low-grade gliomas are formations related to 1 and 2 degrees of malignancy.
Characterized by slow formation, from the onset of tumor development and to the first signs of the disease, several years pass.
Most often, gliomas of this type are found in the cerebellum and in the cerebral hemispheres.
Gliomas of low grade occur in children and young people under the age of 20, whereas tumors of grade 3-4 grade are more characteristic of people of age.
Symptoms of a tumor
Symptoms of growing glioma directly depend on which part of the brain the tumor occupies. Neoplasma compresses tissues and membranes, which leads to the emergence of cerebral symptoms:
- To severe headaches, which are not stopped by taking analgesics and antispasmodics.
- Appearance of gravity in the eyeballs.
- Nausea, which occurs as a result of pain in the head. Patients complain about periodic vomiting, which also occurs at the peak of the attack.
- Convulsions.
If glioma squeezes the cerebrospinal fluid and the ventricles of the brain, then hydrocephalus develops and intracranial pressure rises.
In addition to cerebral symptoms, glioma also affects the appearance of focal manifestations of the disease, it is:
- Dizziness.
- Shakiness in normal motion.
- Visual impairment.
- Hearing loss or tinnitus.
- Speech function disorder.
- Decreased sensitivity.
- Decreased muscle strength, which causes paresis and paralysis.
Patients with brain glioma are also diagnosed with mental changes, which are expressed by the disorder of all types of memory and thinking, and by certain violations of behavioral function.
Causes of
It is established that gliomas begin to develop from glial tissue and its cells.
The examination of patients allowed them to detect "windows of malignant vulnerability", that is, the main cause of the disease is genetic disorders, or rather, changes in the structure of the gene, designated as TP 53. What provokes these changes is not clear.
Diagnostics
Glioma of the CNS should be detected when its size is still minimal, this facilitates treatment. Therefore, if you have the above symptoms, you should consult your doctor.
Usually, the initial examination of the patient is done by neurologists. They should carefully examine the patient, collect all complaints and find out the sequence of the appearance of signs of the disease. Neurological examination includes assessing changes in coordination of movements, in sensitivity, muscle strength and tone.
Video conference on diagnostics and surgical treatment of malignant brain gliomas:
Diagnostic procedures prescribe:
- Electromyography and electroneurography. These two examinations reveal changes in the neuromuscular apparatus.
- Echoencephalography is necessary for the detection of signs of hydrocephalus and the deviation of the median brain structures.
- An ophthalmologist should be examined if the patient has visual dysfunction.
- EEG is prescribed if there is a convulsive syndrome.
- MRI.This method of diagnosis is considered the most accurate, because it shows the location of the glioma, its size and the process of infiltration.
- Angiography is assigned to assess cerebral vessels.
- CT is performed in place of MRI or as an additional procedure.
- Lumbar puncture allows you to take a spinal fluid for analysis. A survey is required to identify atypical cells.
An accurate diagnosis is made only after a microscopic examination of a tissue sample from a tumor is made. Bioptate is taken either during surgery, or during a stereotactic biopsy.
Glioma needs to be differentiated from abscess, intracerebral hematoma, epilepsy and other types of primary CNS tumors.
Treatment of patients
Completely removed glioma is possible only at the first degree of its malignancy and in the event that this tumor is not located in a hard-to-reach place of the brain. Gliomas of the subsequent degrees of development already infiltrate into surrounding tissues and therefore the neoplasm is difficult to cut off from healthy tissues.
Modern advances in medicine, such as MRI scanning, microsurgery, intraoperative mapping give more opportunities for neurosurgeons, but until now this type of primary tumors are not surgically treated.
Contraindications for operation:
- Severe patient.
- Distribution of glioma on both hemispheres.
- Difficult access to education.
- Presence of other malignant lesions of the brain.
The effectiveness of chemotherapy and radiation is significantly lower if the glioma occupies the central part of the brain, since this place is not easily affected.
Life expectancy forecast
Gliomas, regardless of their location, belong to a group of incurable pathologies. Only a quarter of patients survive, and to them, above all, those who applied at an early stage, and the localization of their glioma allows for a successful operation.
With a high degree of malignancy, people live from one year to two years. But even with effective treatment in 80% of cases there is a relapse of pathology.
Video about modern standards and perspectives of treatment with malignant gliomas: