Glioma
Introduction
Introduction to glioma Gliomas (glioma) account for about 46% of intracranial tumors. The incidence of glioma in brain tumors is the highest, and the peak age of comprehensive onset is 30-40 years old, or 10-20 years old. Glioma in the cerebral hemisphere accounts for 51.4% of all gliomas, with astrocytoma being the most common, followed by glioma and oligodendroglioma. The ventricular system is also the site of glioma. , accounting for 23.9% of the total number of gliomas, mainly for meningioma, medulloblastoma, astrocytoma, cerebellar glioma accounted for 13% of the total number of gliomas, mainly astrocytoma. Brain stem glioma is a general term for gliomas that occur in the pons, midbrain, and medulla. According to statistics, there are two peaks in the age of onset. The first peak is 5 to 10 years old, and the second peak is 40 to 50 years old. Therefore, it can be divided into children and adults. Children are relatively more common, accounting for 10% to 20% of all central nervous system tumors in children, accounting for 30% of children with posterior fossa tumors. basic knowledge The proportion of illness: 0.001% Susceptible population: the peak age of comprehensive onset is 30-40 years old, or 10-20 years old Mode of infection: non-infectious Complications: mental retardation, intellectual retardation
Cause
Cause of glioma
Chemical factors (20%):
In recent years, it is believed that carcinogen methyl nitrourea or ethyl nitrosourea can cause glioma by oral or intravenous injection. Some foreign scholars can use some viruses to induce small tumors in various animals, but on humans. Unable to confirm. It is recommended to use some Chinese herbal extracts. Nowadays, ginsenoside Rh2 (protective) is used as an auxiliary treatment to replenish vital energy, increase white blood cells, enhance immunity and resistance, and inhibit the growth and proliferation of cancer cells. At the same time, gliomas are not very sensitive to chemotherapy, so choosing these aids can often achieve twice the result with half the effort.
Genetic factors (15%):
Genetic factors, gene chain inheritance, are similar phenomena between biological parents and offspring, and between offspring individuals. Genetics generally refers to the phenomenon that the traits of the parent are expressed in the next generation, but genetically refers to the phenomenon that the genetic material is passed from the upper generation to the offspring. In recent years, gliomas have been considered to have a genetic predisposition.
Brain embryo tissue is abnormally developed.
Pathogenesis
1. Fiber type: It is a common type. There are glial fibers in the tumor, which is the main difference from the original type. The texture of the tumor is tough, and the section of the diffuse fiber type is white, which is indistinguishable from the white matter. The adjacent cortex is often infiltrated by the tumor, the color becomes darker, and the boundary with the white matter is blurred, and the center of the tumor may have cystic changes. The boundary lightening of the focal fiber type is mainly found in the cerebellum and often has cystic changes. There are glial fibers in the interstitial space, which are distributed between the tumor cells and the tumor cells are fibrous astrocytes.
2, the original type: is the least seen type. The cut surface is translucent and uniform jelly-like, deep invading white matter, unclear boundary, often denatured, forming cysts. Under the microscope, the tumor consists of protoplasmic astrocytes.
Prevention
Glioma prevention
Glioma is caused by the interaction between congenital genetic risk factors and environmental carcinogenic factors. In prevention, it is mainly concerned with whether there is a family history of genetic disease, and at the same time, it should be kept away from carcinogenic factors.
Complication
Glioma complications Complications, mental retardation, mental retardation
Foreign literature reports that the incidence of intracranial hypertension is 15% to 23.3%, while this group is 53.1%, which is related to the advanced stage of the disease. A small number of children have mental retardation and mental changes (strong crying or strong laughs, etc.).
1. Glioma will not metastasize.
2, glioma is very easy to relapse, the reason is that the boundary between the tumor and normal brain tissue is unclear, it is difficult to completely remove the surgery.
3, lymph node enlargement indicates inflammation, should go to the hospital for examination.
4. If the tumor recurs, you can consider reoperation.
Symptom
Symptoms of glioma Common symptoms Visual field changes Cerebrospinal fluid Increased intracranial pressure Sensory disorder Dementia Ataxia Mental disorder Head enlargement Unstable dysphagia
1. Astrocytoma: The general symptoms are increased intracranial pressure, headache, vomiting, optic nerve head edema, visual field changes, epilepsy, diplopia, cranial enlargement (childhood) and changes in vital signs.
2, medulloblastoma: 1 tumor growth is fast, high intracranial pressure symptoms are obvious. 2 cerebellar dysfunction manifested as gait, unstable walking and so on. 3 double vision, facial paralysis, enlarged head (child), cough and so on. 4 Tumor metastasis is an important feature of medulloblastoma.
3, ependymoma: 1 increased intracranial pressure symptoms. 2 symptoms of brain stem compression (vomiting, coughing, difficulty in pharynx, hoarseness, difficulty in breathing), cerebellar symptoms (unstable walking, nystagmus, etc.) and hemiplegia, dyskinesia on the eyeball. 3 The recurrence rate after surgery is almost 100% prone to intraspinal metastasis.
Examine
Examination of 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 a low or equal density occupancy of the brainstem, can also be a mixed density, tumors with less solid 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, brain stem shape is enlarged, the boundary is unclear, showing uneven enhancement, the degree is related to the malignancy of the tumor, may be associated with intratumoral hemorrhage, occasional cystic changes.
Diagnosis
Diagnosis and diagnosis of glioma
Differential diagnosis
Brain stem glioma is a general term for gliomas that occur in the pons, midbrain, and medulla. According to statistics, there are two peaks in the age of onset. The first peak is 5 to 10 years old, and the second peak is 40 to 50 years old. Therefore, it can be divided into children and adults. Children are relatively more common, accounting for 10% to 20% of all central nervous system tumors in children, accounting for 30% of children with posterior fossa tumors.
One or more cranial nerve palsy is often an important feature of brain stem tumors, and 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 and vagus nerve. Symptoms can be expressed as intraocular oblique and double vision, facial paralysis, swallowing and sputum, ptosis, pupil dilation, and light reflex disappear. When the tumor damages the pyramidal tract at the same time, there will be characteristic cross palsy (ipsilateral cranial nerve damage combined with contralateral limb hemiplegia). The pyramidal tract sign is often bilateral, and the cranial nerve damage is more severe on the contralateral side. Tumor invasion of the cerebellum-dentate nucleus-red nucleus-thalamic bundle can cause cerebellar damage (64.6%), manifested as gait instability, limbs, and nystagmus.
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.
