parietal tumor
Introduction
Introduction to parietal tumor The incidence of tumors in the parietal lobe was lower than that in the temporal lobe, and the tumor was mostly glioma, accounting for 8.52% of the intracranial glioma; followed by meningioma, accounting for 6.50% of the intracranial meningioma; followed by metastasis tumor. Occurs in adults. The function of the parietal lobe is very complicated. It mainly analyzes and synthesizes various sensory information to distinguish and determine the nature and location of the stimulus. Therefore, the damage of the parietal lobe tumor is mainly manifested as the sensory disturbance of the contralateral half body. Most patients can have affirmative symptoms and signs, especially with localized sensory seizures, which is more valuable for localization diagnosis. After decades of research on the structural loss of the parietal lobe, hemiplegic ignorance, deorientation, Gerstmann syndrome, etc., people's understanding of parietal symptoms has been further improved. According to the symptoms and signs of the patient, a more accurate diagnosis can be made. However, there are a few cases, especially slow-growing meningioma, even if most of the parietal lobe is involved, no obvious symptoms can appear. basic knowledge The proportion of illness: 0.001% Susceptible people: good for adults Mode of infection: non-infectious Complications: Acne
Cause
Top lobe tumor etiology
The cause of this disease is the same as that of other parts of the body. It is still not fully understood. A large number of studies have shown that there are oncogenes on the chromosomes of the cells and various congenital causes can cause them to occur. Possible factors for inducing this disease are: genetic factors. , physical and chemical factors as well as biological factors.
Prevention
Parietal tumor prevention
Primary prevention refers to the promotion of health and the reduction of risk factors. This first line of defense is to promote the healthy lifestyle of the general population and reduce the harmful factors in the contact environment, so as to completely avoid the occurrence of cancer. In addition to preventing air, water, food and workplace carcinogens and suspected carcinogens, lifestyle changes in smoking, drinking and other bad habits are primary prevention.
Complication
Parietal tumor complications Complications
The cause is finally combined with lung infection, hemorrhoids and other deaths.
Symptom
Parietal tumor symptoms common symptoms hemianopia vision deformation sensory disorder anxiety reading
The damage caused by the parietal tumor is mainly caused by the sensory disturbance on the contralateral side of the lesion, and it involves functions such as visual and language.
Sensory disorder
The sensory disturbance is divided into general sensory disturbance and cortical sensory disturbance. The general pain caused by the parietal lobe tumor is not obvious. Even if it occurs, it occurs at the distal end of the limb, showing a very slight glove or sock-type sensory disturbance. This is because the thalamus also receives partial pain, caused by the impulse of warm sense. The cortical sensory disturbance is mainly manifested by the positional sense of the contralateral limb of the lesion, two points of resolution, tactile localization and visual pattern disorder, such as the patient's closed eye condition. Under the weight of the object held by the hand, although it can be felt, but can not judge the weight, size, shape, texture, etc. of the object, even the simple number written on the skin can not be recognized, therefore, can not complete the object Comprehensive analysis, called loss of solid sensation, is the result of extensive destruction of the lobular lobes in the central posterior gyrus. Cortical sensory dysfunction can also be manifested as sensory neglect. When stimulating the affected limb, the sensation can be completely normal or slightly reduced. If both limbs are stimulated at the same time, only the feelings of the healthy limbs are caused, while the affected limbs are completely ignored, and the factors that stimulate the affected limbs have been removed. Later, the patient was still in a period of time there is a feeling by the stimulus continue to exist, called tactile stranded phenomenon.
2. Body image disorder
The patient's understanding of the autologous structure is difficult. This phenomenon is especially common in the right parietal lobe lesions. The mechanism of the disease is not fully understood yet. There are many clinical manifestations, such as the patient's disregard for his own partiality, not paying attention, as if It has nothing to do with it, no anxiety, called hemiplegia, and the patient completely denies his own partiality. Even when he prompts the patient's limbs to the patient, he firmly denies his own body, sometimes it is considered to be someone else's hand or Feet, or unrelated reasons to explain the reasons for the inability of the limbs to move. This phenomenon is called partiality, and some patients have the feeling of losing their limbs. They think that their limbs are no longer present, and the limbs are not their own. One's own limbs have been lost. The other manifestation is that one or more limbs are felt. This kind of performance is called polyphabia. In addition, there are patients with finger agnosia, left and right orientation obstacles, and self-forgetting. Symptoms, etc.
3. Loss of structure
Loss of structural disorder, also known as structural apraxia, refers to the spatial relationship between spatial object structure, architecture, painting, and pattern. It cannot be correctly recognized and discerned, cannot be combined, and cannot understand the relationship between each other. Correct use of tools to work, resulting in difficult life, clinical use of painting, building blocks and other methods to check, although the patient can imitate, and the various components seem to be still, but lack of layout ability and proportional relationship, or upside down, left and right, arranged Too crowded or scattered, lost the shape of the original, no space concept, lack of three-dimensional relationship, the mechanism of the loss of structural disease, has not yet reached a consensus.
4.Gerstmann syndrome
Seen in the posterior and posterior part of the parietal lobe, the upper margin and the parietal lobe migrated to the occipital lobe lesions, the clinical manifestations are mainly finger agnosia, left and right misorientation, loss of writing, miscalculation, finger agnosia The most common, often bilateral, the patient's designated finger, the finger can not recognize, the use of the finger confusion, especially with the thumb, little finger, middle finger is the most serious, finger agnosia is an important part of Gerstmann syndrome, left and right Deviation disorder can not distinguish between the left and the right when identifying other people's limbs, but it does not necessarily affect the left and right orientation of the surrounding environment. The loss of writing is mainly caused by difficulty in writing, but there is no obstacle when reading or copying. The miscalculation is obviously obstacled by the calculation of the calculation.
5. dyslexia
Left cerebral hemisphere occipital lobe lesions often lead to dyslexia, that is, loss of reading ability, accompanied by writing dysfunction, dyslexia can be divided into two types:
(1) Subcortical dyslexia:
The patient can't read the written or printed words and can't read the sound, but the spontaneous writing and copying are not obstructed. The patient can rely on writing to express his own thoughts, but can't read the articles or letters he wrote, and the dyslexia under the cortex. Accompanied by hemianopia.
(2) Cortical autism:
In addition to not knowing and reading texts, patients are often accompanied by loss of writing, and can not be dictated, copied and spontaneously written.
6. Seizures
Most of the seizures caused by parietal tumors are localized seizures, and often are sensory, manifested as contralateral paroxysmal paresthesia. The first part is more common with thumb and index finger, but the beginning of the foot is not uncommon. Hair numbness, electric shock-like sensation or pain-based, extending to a fixed direction, but can also be a localized tendon or clonic motility, or first with sensory symptoms followed by seizures of motor symptoms, or even evolved into epilepsy Seizures, after the onset, there are often two points of discrimination, physical sense, positional awareness and other transient sensory disturbances.
7. Hemiplegia or single
Topal lobe tumors often have hemiplegia or monoterpene of the contralateral limbs. The sputum is not the symptoms of the parietal lobe itself. It is caused by the tumor invading the movement area. At the same time as the sputum symptoms appear, deep reflex hyperthyroidism can be seen, but the muscles can be seen. The increase in tension is not obvious.
8. Other
In the case of parietal lobe tumors, there may be cases of muscle atrophy of the contralateral limb, visual illusion caused by visual distortion, contralateral 1/4 blind or isotope hemianopia, and obstacles in understanding the geographical environment.
Examine
Parietal tumor examination
1. Skull flat film
The parietal lobe tumor is the same as the tumor in other parts of the cerebral hemisphere. Depending on the nature of the tumor, some tumors can also cause different degrees of changes in the skull. For example, meningioma can cause bone hyperplasia or destruction of a small range of intracranial plates.
2. Ultrasound
Ultrasound examination of parietal tumors often showed a midline wave shift to the opposite side.
3. EEG
The electroencephalographic features of parietal lobe tumors are characterized by a wide range of localized delta or waves, which are generally dominated by the top of the diseased side, spreading to the occipital, posterior, anterior, posterior, posterior, etc. Especially in the case of the top cerebral palsy, the slow wave appears more widely, and it is often difficult to distinguish it from the occipital tumor. When the delta wave is confined to the top or the occipital occipital, there is a greater possibility of parietal tumor, deep parietal tumor. The localized wave is generally not obvious. It shows 5 to 7 times/second localized scattered or continuous wave and lazy wave. The parietal tumor is easy to cause the diseased hemisphere (about 30%) or both hemispheres (about 10 %) A wide range of scattered slow waves, sometimes showing extensive spine waves, and the background or both sides of the background alpha waves are often turbulent.
4. Cerebral angiography
The characteristics of cerebral angiography of parietal tumors are:
In the anterior and posterior images, the anterior cerebral artery is displaced in parallel, and the convex branch of the middle cerebral artery is moved downward or partially. The lateral position is like the upper middle artery, and the blood vessel is compressed.
(1) Parietal cerebral palsy:
The anterior and posterior images showed that the anterior artery was displaced to the contralateral side, which was linear, and the distal displacement was significant. When the lateral image showed the tumor front, the periorbital artery and its branches were curved; when the tumor was posterior, the periorbital artery was The pressure is pushed forward or the periorbital artery is pushed forward to bend, the end branch is straightened or curved, and the middle artery group pushes forward slightly, or its tip is dispersed.
(2) Parasagittal parasitic sinus tumor:
The anterior and posterior images showed that the anterior artery was displaced to the contralateral side, the upper end was obvious, the periorbital artery branch was curved downward, the cerebral palsy was positive, the middle cerebral artery group was under pressure, and the lateral image was seen moving downward. Position, the periorbital artery is slightly moved down or straight, so it is mostly meningioma, so it often shows that the anterior and middle cerebral arteries are tortuous.
(3) Frontal tumor:
The anterior and posterior images showed that the anterior cerebral artery was curved to the contralateral side, and the middle cerebral artery group was slightly depressed and displaced. The whole vascular change showed no shape, and the lateral image showed that the middle cerebral artery was compressed and flattened. More obvious, the elevation of the ascending branch artery is more significant than that of other parts of the tumor, which is characterized by being squeezed, straightened, and branches are separated from each other.
5. Ventricular angiography
Because the posterior part of the lateral ventricle and the triangular area correspond to the parietal lobe, the parietal lobe tumor shows more depression of the lateral ventricle, transparent septum, and the third ventricle is obliquely shifted to the contralateral side. Tumors in the occipital region can cause the triangle and the occipital angle to move down.
6. Brain CT examination
CT diagnosis of intracranial tumors, especially supratentorial tumors, has more advantages than other diagnostic techniques, and is currently an ideal diagnostic method.
Diagnosis
Diagnosis of parietal tumor
Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.
Differential diagnosis
Chronic subdural hematoma
Chronic subdural hematoma of the parietal lobe is a common clinical disease. It is more common in young and middle-aged people. Its clinical course is similar to that of brain tumor, but it has a history of head trauma. The injury is mild, so it is often forgotten by patients. Do not take the initiative to tell, even when asked about the medical history can not remember, after several months or even years after the clinical symptoms gradually appear, early symptoms are mostly headache, dizziness, can also detect localized sensory epilepsy or partial sensory disturbance, double check Symptoms and signs of parietal lobe lesions can be found. Chronic intracranial pressure examination may have a manifestation of chronic intracranial pressure. Usually there is no fracture line. Ultrasound examination reveals midline wave shift (bilateral may not shift), EEG examination There may be localized slow waves, and carotid angiography often shows avascular area for definite diagnosis.
2. Brain abscess
The incidence of parietal lobe abscess is more awkward, the frontal lobe is not seen, mostly blood-borne infection, and the systemic manifestations in the acute phase (high fever, peripheral blood like polymorphonuclear leukocytosis) and acute intracranial pressure increase, etc. It shows that the cerebrospinal fluid has suppurative changes, which is easy to be diagnosed with brain tumors. However, the chronic parietal lobe of the parietal lobe has a longer course. The clinical symptoms are similar to those of the parietal lobe, and most of them are difficult to identify. Only the surgical exploration can confirm the diagnosis.
3. Cerebrovascular disease
In the middle cerebral artery disease, such as vascular malformation, arteriovenous fistula, aneurysm, arteriosclerosis, etc., there may be parietal signs, the top of the middle cerebral artery, the occipital occipital joint is prone to ischemic softening, the advantage There is a loss of writing when the hemisphere is softened back, and the loss of reading and Gerstmann syndrome appear. Care should be taken to identify the tumor.
