Tumors of the central nervous system ( brain , spine ) - Causes, Symptoms and Treatment .MF .
Brain tumors - a group of intracranial structures, different composition of their constituent cells, with the current, position, height, but with equally severe course and prognosis.Not operated patients, without exception, are doomed to failure.
Located in the limited space of the skull, a growing tumor or brain structure moves or grows in them, disrupting vital organ.The reasons for the development of tumors and triggers uncontrolled cell growth is unknown.In recent marked increase diseases.Playing the role of age, family history, radiation, exposure to chemicals in the workplace (for example, in the petroleum industry).
classification of tumors by cell composition:
1. neuroectodermal - glioma:
- mature (medulloblastoma)
- immature (spongioblastoma)
3. pituitary - pituitary adenoma;
4. - heterotopic;
5. - metastatic - cancer usually carcinomas of lung, breast, gastro - intestinal tract, thyroid, melanoma of the skin;
6. - infectious and parasitic granuloma
Tumors may be extracerebral - meningiomas, neuromas and intracerebral - glioma.
- tumoroznoe for - a slow gradual emergence and exacerbation of symptoms, focal associated with compression of the brain tumor and the symptoms of increased intracranial pressure;
- vascular - acute onset for stroke type may hemorrhage into the tumor;
- epileptiform - acute onset of an epileptic seizure;
- inflammatory for - the slow development of symptoms by type of meningoencephalitis - inflammation of the brain and its membranes;
is an isolated liquor - hypertensive syndrome.
The clinical course of isolated:
1- compensation clinical phase - characterized by asthenic syndrome - weakness, fatigue, disturbances of the emotional sphere - nervousness, irritability.Physician practically not detected either lobular or cerebral symptoms.
2- Phase Clinical subcompensation - characterized by the partial violation of labor and home adaptation at the general satisfactory condition.In this phase, the formulation of timely diagnosis.Neurologist discovers the phenomenon of irritation - different sensory disturbances - paresthesia, hyperpathia, epipripadki, hallucinatory phenomena.Syndromes of loss functions are expressed softly, mostly revealed a difference of tendon reflexes, asymmetric sensory symptoms - numbness, sometimes a decrease in muscle strength - paresis.Among the brain symptoms - headaches, moderate, at night and in the morning.An examination by an ophthalmologist is determined or even a normal fundus, or the initial effects of stagnation of the optic nerve.
3- phase of moderate clinical decompensation - characterized by complete or almost complete violation of labor and significantly reduced consumer adaptation of the patient.The general condition of moderate severity.The clinical picture is growing headache, accompanied by nausea and vomiting, confusion appears.Symptoms of loss functions prevail over the symptoms of irritation.Determined paresis and paralysis, possible violations of speech, swallowing, orientation, criticism.
4- Phase gross clinical decompensation - a serious condition of the patient, bed sick.Frequent and severe headache with vomiting, disturbance of consciousness of varying severity.Perhaps the development of secondary dislocation syndrome - loss of oculomotor nerves - paresis gaze upwards, pupils different size (anisocoria), violation of the visual fields, bilateral pathological signs, meningeal signs, dysfunction of the cardiovascular system and respiration, speech, swallowing.Diagnosis is considered delayed in this stage.
5- The terminal phase - rough disorder basic life functions, impaired consciousness to coma, severe disturbance of cardio - vascular system, abnormal breathing, fever - hyperthermia, changes in muscle tone.Probably bleeding into the tumor, brain swelling, dislocation of the brain.It lasts for hours - days - the state is irreversible.
symptoms of tumor growth:
1. cerebral symptoms of brain tumor - symptoms of increased intracranial pressure due to compression of the blood vessels - arteries and veins, likvoroprovodyaschih tract, brain edema as a result of the toxic effect of tumor products and violations of the symptoms of the higher nervous activity as a result of violations of bondsbetween the cortex and subcortical structures.The patient feels a headache - bursting, popping up in the second half of the night and in the morning and in the evening decreasing.At an altitude headache nausea and vomiting.The patient is disturbed psyche - the state of lethargy, stupor, absent-mindedness.
meningeal signs appear, there may be seizures.
2. Focal symptoms - alopecia - caused by the direct location of the tumor;
3. Symptoms of the neighborhood - the tumor grows and compresses the surrounding tissues;
4. Symptoms of long-term - as a result of compression of the brain and offset structures.
Meningiomas - usually benign tumor that develops from the endothelium of the meninges and are characterized by slow growth.Most often it is a single node, the joint with the dura mater, a well delimited from the medulla, they push aside, forming a place for themselves.Sometimes cysts are formed.Most appear along the veins.
Meningioma of the optic nerve, infiltrating the soft tissue of orbit
Meningosarkomy - malignant tumor sprouting growth, necrosis and decay, without the capsule.
Astrocytomas - a relatively benign tumor of macroglia cells (astrocytes).They are characterized by slow growth of germinating, without clear boundaries, are prone to the formation of cysts.
Glioblastomas - malignant tumors of macroglia cells are characterized by rapid growth sprouting from the collapse, seizures, which massive mental disorders.
Glioma of the brain depending on the location (location) of the tumor can be a variety of neurological symptoms.
frontal lobe tumors manifest mental disorders, seizures, impaired innervation of the facial muscles, speech.The patient is indifferent (apathetic), reduced the criticism to his condition can perform ridiculous acts not oriented in time and place.
temporal lobe of the brain - is epileptogenic zone.For epipripadkov this localization is typical aura (forerunners of the attack) - auditory, olfactory, gustatory.Aura is often negative - smells putrid, frightening visual vision may "shine" before his eyes.Disturbed sight - falls viewing areas - quadrants, halves (hemianopsia).
defeat the parietal lobe of the brain gives violation of difficult types of sensitivity - articular - muscular sense (the patient can not determine which finger is taken in hand, which is tilted), a sense of discrimination (can not determine how many times touched the doctor to paralyzed limbs and blunt object or acute)disappears sense of weight, I lost the ability to count, write, speak, read.
occipital lobe - a visual analyzer.When tumors are possible visual hallucinations, sparks before the eyes, visual field disturbances, with bilateral lesions - blindness.
With the defeat of the cerebellum appear static disorders, coordination - the patient falls, hyperkinesis (jerks), changed handwriting.
Pituitary tumors - neuroendocrine tumors is characterized by visual and endocrine disorders.Adenomas may be hormonally inactive and hormonally active, that is hard to produce hormones - prolactin, growth hormone, corticotropin.When you increase the production of prolactin in men appears gynecomastia - increased mammary glands, appear allocation of these reduced libido and potency in women appears laktoreya (allocated milk), disturbed menstrual cycle.With an excess of growth hormone (GH) is developing acromegaly - facial features gradually change - increasing the nose, eyebrows, chin, hands and feet grow.
Increase in acromegaly stop
With the increased secretion of corticotropin developing severe disease - pituitary - Cushing - high blood pressure, obesity, special face, neck and hips.
brainstem lesions are characterized by the development of alternating symptoms when the tumor on the side of the affected cranial - cerebral nerves, and on the opposite side there are motor and sensory disturbances.This disturbed speech, swallowing, cardio - vascular and respiratory system.
Listed Not all possible symptoms, but the most frequent combinations thereof.Everything happens individually, depending on the location of the tumor process and its development.
Home for timely diagnosis and treatment to consult a doctor - a neurologist.The emergence of similar systematic headaches, changes in mood, behavior, intellectual ability, loss of consciousness, visual disturbances, visual field, double vision, sensory disturbances and muscle weakness should lead you to the survey.
- general clinical and biochemical blood tests;
- for suspected pituitary adenoma - analysis to determine the level of hormones;
- inspection ophthalmologist - fundus, the definition of the fields of view;
- lumbar puncture;
- it computed tomography and magnetic resonance imaging;best quality diagnostics with contrast, the most sensitive magnetic resonance tomography with the induction of the magnetic field of 1.5 Tesla;
Here is the magnetic - resonance imaging
- consultation of a neurosurgeon, angiography.
Also conducted a comprehensive examination of the patient to rule out a possible metastasis of the tumor and the presence of lesions in other organs.Angiography can be performed by purpose neurosurgeon.
Treatment of brain tumors
Treatment - operative.Neurosurgeon determines the necessity, possibility and scope of the operation.Removal of the tumor passes histological examination to confirm the diagnosis.Depending upon the histological diagnosis address issues need of radiation and chemotherapy following surgery.For brain tumors generally used remote gamma-therapy.Depending on the type of tumor and oncologist radiologist compiled various schemes and doses of radiotherapy and chemotherapy.
modern center "Gamma Knife" to conduct an effective non-invasive removal of the depth of the brain tumors.The Russian center "Gamma Knife" are at the Institute of Neurosurgery named after NN Burdenkoin Moscow, in the center of radiosurgery in St. Petersburg.In Ukraine, in Kiev - Cyber Clinic Spizhenko - Center of radiosurgery Cyberknife.
treatment of pituitary adenomas minimally traumatic held transnozalno, but requires further observation and endocrinologist, gynecologist, sexologist, andrologist to correct hormonal imbalance.
Tumors of the spine and spinal cord:
1. Metastatic - often from lung, breast, prostate, ovarian, kidney - often affects the body and vertebral arches;
2. Ekstramedulyarnye tumor - by location are subdural (meningiomas, neuromas, vascular tumors), tumors of the dura mater;extradural (fibroma, lipoma, sarcoma, neuroma), primarily growing tumors of the vertebrae - osteoma;intramedullary tumors (glial, epipdimomy);ekstramedulyarnye.
clinical picture depends on the nature of the tumor, its location, height, effect on the surrounding tissues - blood vessels, nerve roots, spinal cord, meninges, venous reservoirs, often there is pain, swelling with sensory and motor disabilities.The neurologist can detect when viewed radicular syndromes and syndromes of spinal cord lesions.Perhaps the first appearance of acute symptoms of the tumor on the spinal stroke type.Depending on the symptoms detected and expected topical lesion doctor prescribes the necessary research and consultations with specialists.
Engage in self-diagnosis and self-treatment the more impossible and unacceptable.When the public - or health violations, systematic pain is necessary to come to the doctor and talk about their symptoms.In later use, the large size of the tumor, its location, deep, germination in the vital structures surgery may already be impossible.
Doctor's consultation on brain tumors
Question: Is there contraindications for magnetic - resonance therapy?
The answer is yes - the presence of a pacemaker, ferromagnetic and electronic ear implants, large metal implants and fragments installed the Ilizarov apparatus, hemostatic clips on the vessels of the brain.
question: what inspection is better to make a computer or magnetic - resonance imaging?
Answer: it solves the doctor for further diagnosis is sometimes necessary to do both studies, since they complement each other.
Question: What is the effectiveness of the treatment?
A: evaluates the effectiveness of the treatment only time - the longer the tumor does not grow - the more effective the treatment.
neurologist Kobzev SV