Brain Tumors

Brain tumors may be benign or malignant, primitive or metastatic.Benign tumors are most common. Malignant tumors represent about 1% of all malignancies arising. In terms of pathology, glial tumors are most common, reaching 50-60% of their percentage of the total localized primitive brain tumors. Meningiomas are found in a quarter of patients with brain tumors primitive and schwanoamele represents 10% of these tumors.The term refers to the primitive brain tumor that the tumor originates in the brain parenchyma, meninges, remains embryonic pituitary and cranial nerve roots.Metastatic brain tumor term means that the tumor of origin is somewhere other than brain tumors in the developing brain cancer cells after cantonarii at this level, cells via the blood flow coming from the tumor of origin. In the case of metastatic brain tumors, the tumor of origin can be anywhere in the body, most often being located in the lung, kidney, prostate or liver.
Metastatic brain tumors are more common than the primitive brain tumors. It is estimated that 15% of patients die annually from cancer shows symptomatic brain metastases. There are a number of pathological conditions that evolve with similar symptoms of an intracranial expansive process, but without it there. These states are known as pseudotumor cerebri, which are infections, metabolic disorders, poisoning.Topographically speaking, more than half of supratentorial brain tumors are located and the third is developing subtentorial.
Histological types of brain tumors:- Gliomas are neoformation's own nerve tissue, they developed out of supporting glial tissue and are the most common brain tumors.In most cases, gliomas are composed of a single type of cell, but several types of related, but the name is based on the tumor cell type is predominant. Gliomas grow by infiltration. Types of glial tumors Astrocytomas (are most common), ependymoma, spongioblastomul, medulloblastoma, glioblastoma multiforme. The last two types are growing rapidly in size and often recur after surgical removal. Patients with astrocytomas have a good chance of cure by surgery, but do not respond to radiotherapy. Gliomas can occur at any age, children are meeting more often medulloblastoma. With time in glioma calcifications may occur, especially if ependimoamelor and ologodendroglioamelor.- Meningiomas have a starting point of the arachnoid, are found most frequently in young adults between 20 and 45 years. Tumors are benign (except as sarcomatous). Feature is that they do not infiltrate the brain parenchyma, but it compresses, so there are chances of cure by surgical removal. These are tumors with a rich blood supply and develop in the vicinity of venous sinuses, which sometimes makes it difficult for their surgical removal. Evolving near the polar head, often found on X-ray area is the skull bone osteolysis in contact with the tumor. Types of meningiomas according to location: parasagitale meningiomas, meningiomas olfactory tubercle Bestsellers meningiomas, sphenoid wing meningiomas, meningiomas convexity, posterior cerebral fossa meningiomas.- Paraselare and pituitary adenomas is accompanied by endocrine disorders (by affecting the pituitary gland) and disorders of the visual field (hemianopsia heteronima).- Acoustic neurinomul develop the ponto-cerebellar angle, meeting at the middle-aged adults. Diagnosis should be made as soon as possible in the early stages of disease, for surgical treatment to have maximum efficiency.- Brain metastasis is made by marrow and predilection to develop in the area between the white and gray matter. The most common primary tumors of brain metastases are giving lung cancer, breast cancer (spread to the cerebellum), gastrointestinal tumors and malignant melanoma.- Other tumor types: tuberculoamele, Lueta granulomas, foreign body granulomas, vascular tumors and aneurysms, cerebral echinococcosis, cysticercosis, cerebral abscess, cerebral hematoma.
Pseudotumoral processesThese pathological processes lead to intracranial hypertension, but do not fit into clinical pictures that follow. These processes are inflammatory nature: arahnoidiene cysts, Arachnoiditis the posterior fossa, Arachnoiditis optochiasmatica, inflammatory occlusion of the aqueduct of Sylvius.
ClinicalBrain tumors are clinically manifested by one of the following syndromes: subacute progression of a focal neurological deficit, seizures or non-focal neurological impairment. Metastatic tumors are demonstrated by systemic symptoms as anorexia, weight loss, malaise and feeling feverish.
Focal neurological syndromes are the result of compression of white matter neurons and the effect of the tumor mass (tumor growth) and the swelling which it produces. Focal neurological syndromes are:
Frontal lobe syndromeFor tumors located in the frontal lobe of the outbreak the following symptoms:psychiatric disorders, epilepsy, seizures grand mall seizures Jacksonian focused, aphasia and clips, facial nerve paresis, motor problems that become even more pronounced with more interested tumor area as the frontal lobe motor ...more about the syndrome of frontal lobe
Parietal lobe syndromeA tumor that develops in the parietal lobe gives the following clinical manifestations:- Sensitive seizures, sensitivity disorders, disorders somatognozice.motor disorders evidenced by a slight hemiparesis, upper limb muscular atrophies controlateral (thenar and hypothenar Eminence).more about the parietal lobe syndrome
Temporal lobe syndromeIf a tumor in the temporal lobe, and speech disorders are common disorders psihice.Hipertensiunea intracranial hipoestezii superficial eye disorders ...more about temporary lobe syndrome
Occipital lobe syndromeOccipital lobe tumors are rare. Visual disturbances are one of the most important signs of tumors at this level, speech disorder, if interested and parietal lobe tumor; controlaterala hemiparesis, cerebellar disorders in the form of balance disorders essentially of bulk.more about the occipital lobe syndrome
Posterior cerebral fossa syndromeTumors that develop at this level in the cerebellum, causes serious disruptions in the normal flow of cerebrospinal fluid. Because of this, is dominated by clinical symptoms of intracranial hypertension syndrome.more about cerebral posterior fossa syndrome
Diagnostic LaboratoryCT scan and MRI (magnetic resonance imaging) are imaging tests that accurately specify the topography of brain tumors. Tumors appear as formations hiperdense, replacing the space. Differential diagnosis of a cyst with fluid is easy, it appeared as a hypodense image imaging examination. It is also essential to do a biopsy to highlight the tumor histology and to guide treatment.
TreatmentIt is difficult to standardize a treatment for brain tumors. In most cases this treatment involves mixed teams of surgeons, radiotherapists, chimioterapeuti and collaboration with other medical specialties. Before any surgery is performed tumor biopsy to determine histologic type of tumor. Fragment is a tumor biopsy collection to study it, and is more difficult to carry with straw as the tumor is located deep within the brain parenchyma.Histopathological examination is particularly important because it dictates treatment steps. Neurosurgical intervention aims to remove the tumor mass as possible as little damaging the brain parenchyma. The methods used are classical operators trepanarea skull, craniotomy (especially for benign tumors), craniectomia the posterior fossa. The best results are obtained by using modern means of intervention such as surgery or binocular microscope with carbon dioxide laser. In advanced stages of cancer surgery that can only do is external ventricular drainage of cerebrospinal fluid ventriculo-peritoneal or surgical treatment should be filled with the drug. It is used anticonvulsants, corticosteroids, mannitol (to reduce intracranial pressure) and type diuretic furosemide.
PrognosisFrom neferiricre, the prognosis is grim in brain tumors, often not being able to remove the tumor entirely, especially if it is developed intraparenchimatos. In many cases, palliative treatment in general, improving the patient's condition, but failing to suppress the causal factor. Especially in the case of metastatic brain tumors, they are just the tip of the ice-bearg of the disease, primary tumor is usually in an advanced stage. Glucocorticoids, and anticonvulsants radiotherapy improves quality of life.Glucocorticoids in high doses have a beneficial effect on symptoms of metastases, the quality of life inbunatatindu rapidly, within hours. Anticonvulsants are used to prevent seizures or to treat any existing ones.