Pediatric Brainstem Glioma
Introduction
Introduction to pediatric brainstem glioma Brain stem glioma (gliomaofbrainstem) accounts for 10% to 20% of children with neurological tumors, and the average age of onset is 5 to 9 years old. Divided into 5 types: localized, cystic, external growth, cervical medullary junction and internal invasive tumors. The first four types are mostly low-grade gliomas, while the internal invasive tumors are mostly highly gliomas and can be metastasized. There are often corresponding cranial nerve damages, such as mouth and eye skew and swallowing bun (VI, VII, IX brain damage), walking squats and limb ataxia (cerebellar damage), etc., the symptoms of intracranial hypertension are relatively small. basic knowledge The proportion of illness: 0.003% Susceptible people: children Mode of infection: non-infectious Complications: mental retardation
Cause
Causes of pediatric brainstem glioma
Glioma (30%):
The nature of tumors is almost all gliomas. Astrocytoma and polymorphic glioblastoma are the most common. Some are ganglion gliomas and ependymoma. The upper part of the brain stem is mainly low-grade malignant stars. The cell tumor and the lower part of the brain stem are mostly glioblastoma.
Fiber type (30%):
It is a common type. There are glial fibers in the tumor. This is the main difference from the original type. The texture of the tumor is tough. The diffuse fiber type is white, which is indistinguishable from the white matter. The adjacent cortex is often infiltrated by the tumor, and the color changes. Deep, the boundary between white matter and white matter is blurred, the center of the tumor may have cystic changes, and the boundary of the focal fiber type is smooth, mainly found in the cerebellum, often cystic, with glial fibers in the interstitial space, cross-distributed in Between tumor cells, the tumor cells are fibroblasts.
Pure pulp type (30%):
It is the least common type. The cut surface is semi-transparent and uniform jelly. The deep invading white matter, the boundary is unclear, often denatured, forming a cyst. Under the microscope, the tumor is composed of protoplasmic astrocytes.
Prevention
Pediatric brain stem glioma prevention
Refer to the general tumor prevention methods, understand the risk factors of tumors, and formulate corresponding prevention and treatment strategies to reduce the risk of tumors. There are two basic clues to prevent tumors. Even if tumors have begun to form in the body, they can help the body to improve resistance. These strategies are as follows:
1. Avoid harmful substances (promoting factors) that can help us avoid or minimize exposure to harmful substances.
Some related factors of tumorigenesis are prevented before the onset, and many cancers can be prevented before they are formed. A report in the United States in 1988 compared the international malignant tumors in detail and proposed many external factors of known malignant tumors. In principle, it can be prevented, that is, about 80% of malignant tumors can be prevented by simple lifestyle changes, and traced back. In 1969, Dr. Higginson's research concluded that 90% of malignant tumors are caused by environmental factors," "Environmental factors", "lifestyle" refers to the air we breathe, the water we drink, the food we choose to make, the habits of activities, and social relationships.
2. Improve the body's immunity against tumors can help improve and strengthen the body's immune system and cancer.
The focus of our current cancer prevention efforts should first focus on and improve those factors that are closely related to our lives, such as quitting smoking, eating properly, exercising regularly, and losing weight. Anyone who follows these simple and reasonable lifestyles can Reduce the chance of cancer.
The most important thing to improve the function of the immune system is: diet, exercise and control troubles. Healthy lifestyle choices can help us stay away from cancer. Maintaining good emotional state and proper physical exercise can keep the body's immune system at its best. Tumors and prevention of other diseases are equally beneficial. Other studies have shown that appropriate activities not only enhance the body's immune system, but also reduce the incidence of colon cancer by increasing the peristalsis of the human intestinal system. Here we mainly understand the diet in preventing tumorigenesis. Some questions.
Human epidemiology and animal studies have shown that vitamin A plays an important role in reducing the risk of cancer. Vitamin A supports normal mucosa and vision. It directly or indirectly participates in most of the body's tissue functions. Vitamin A is present in animal tissues. In the liver, whole eggs and whole milk, the plant is in the form of -carotene and carotenoids, which can be converted into vitamin A in the human body. Excessive intake of vitamin A can cause adverse reactions in the body and -carrot This is not the case with carotenoids, and the low vitamin A content in the blood increases the risk of malignant tumors. Studies have shown that those with low levels of vitamin A intake in the blood increase the likelihood of lung cancer, while those with low blood levels in smokers Levels of vitamin A ingestors have the potential to double lung cancer. Vitamin A and its mixture can help remove free radicals in the body (free radicals can cause damage to genetic material), and secondly stimulate the immune system and help differentiate cells in the body. Ordered tissue (while the tumor is characterized by disorder), some theories suggest that vitamin A can help early carcinogens Invasion mutated cells become reversed the occurrence of the normal growth of cells.
In addition, some studies suggest that supplementation with -carotene alone does not reduce the risk of cancer, but rather increases the incidence of lung cancer. However, when -carotene binds to vitamin C, E and other antitoxin substances, its protective effect. It is shown, because it can increase free radicals in the body when it is consumed by itself. In addition, there are interactions between different vitamins. Both human and mouse studies have shown that the use of -carotene can reduce 40% of vitamins in the body. At E-level, a safer strategy is to eat different foods to maintain a balanced vitamin to protect against cancer, as some protective factors have not been discovered so far.
Vitamin C, E is another anti-tumor substance that prevents the harm of carcinogens such as nitrosamines in food. Vitamin C protects sperm from genetic damage and reduces the risk of leukemia, kidney cancer and brain tumors in their offspring. Vitamin E can reduce the risk of skin cancer. Vitamin E has the same anti-tumor effect as vitamin C. It is a scavenger that protects against toxins and scavenges free radicals. The combination of vitamins A, C and E protects the body against toxins. Better than applying it alone.
At present, research on phytochemistry has attracted widespread attention. Phytochemistry is a chemical found in plants, including vitamins and other substances found in plants. Thousands of plant chemicals have been found, many of which have anticancer properties. The protective mechanism of these chemicals not only reduces the activity of carcinogens but also enhances the body's immunity against carcinogens. Most plants provide antioxidant activity that exceeds the protective effects of vitamins A, C, and E, such as a cup of cabbage. Contains 50mg of vitamin C and 13U of vitamin E, but its antioxidant activity is equivalent to the antioxidant activity of 800mg of vitamin C and 1100u of vitamin E. It can be inferred that the antioxidant effect in fruits and vegetables is far better than what we know. The effect of vitamins is strong, and no doubt natural plant products will help prevent cancer in the future.
Complication
Pediatric brain stem glioma complications Complications, mental retardation
Foreign literature reports that the incidence of increased intracranial pressure is 15% to 23.3%, while this group is 53.1%, which is related to the advanced stage of the disease at the time of treatment. A small number of children have mental retardation and mental changes (strong crying or strong laughter, etc.).
Symptom
Symptoms of pediatric brainstem glioma Common symptoms Orbital facial nerve spasm Ataxia swallowing hairpins sag sag light reflex disappears diplopia contralateral limb hemiplegia eyeball gait instability
One or more cranial nerve palsy is an important feature of brain stem tumors. The first symptom is cranial nerve palsy, which accounts for 24%. The most common cranial nerve damage is the nerve, followed by the facial nerve and the pharyngeal vagus nerve. The symptoms can be expressed as Intraocular oblique and double vision, facial paralysis, swallowing and sputum, ptosis, pupil dilation, loss of light reflection, etc., when the tumor simultaneously damages the pyramidal tract, characteristic cross palsy occurs (the ipsilateral cranial nerve damage combined with the contralateral limb Hemiplegia), the pyramidal tract sign is often bilateral, and the cranial nerve damage is more severe on the contralateral side. When the tumor invades the cerebellum-dentate nucleus-red nucleus-thalamic bundle, it can cause cerebellar damage (64.6%). Unstable gait, limbs and nystagmus.
Examine
Examination of pediatric brainstem glioma
The amount of protein in the lumbar puncture cerebrospinal fluid was normal or slightly higher, and the number of cells was normal.
1. Brainstem Auditory Evoked Potential (BAEP) It has been reported that 6 of 7 children with brain stem tumors have abnormal hearing potential.
2. CT manifests as low or equal density occupying part of the brainstem, and can also be mixed density, tumors with less solid and less cystic changes, uneven enhancement, due to the influence of posterior fossa artifacts, the imaging effect of the tumor is not good. .
3. MRI astrocytoma is mostly long T1 long T2 signal, the brain stem is inflated, the boundary is unclear, and it is unevenly enhanced. The degree is related to the malignancy of the tumor, which may be accompanied by intratumoral hemorrhage and occasional cystic changes.
Diagnosis
Diagnosis and diagnosis of pediatric brainstem glioma
School-age children with intraocular oblique (double vision), peripheral facial paralysis, unclear speech, swallowing, gait, unstable gait, should be thought of the possibility of this disease, if the examination has one side of the cerebral nerve palsy and contralateral (or bilateral The pyramidal signologist can basically determine the judgment of brain stem tumors, and further neuroimaging examination is needed.
It is differentiated from other intracranial tumors and can be identified by means of auxiliary examination and clinical manifestations.
