Glioma of the brain
Brain glioma is a tumor of neuroectodermal origin in the brain. Glioma is the most common brain tumor. Its precursors are specific glial cells. Symptomatically, glioma manifests itself in the form of nausea, headache, vision loss, paralysis and paresis. Sensitivity disorders and limb cramps may also be detected.
The content of the article:
What is a glioma of the brain
Classification of brain gliomas
Symptoms of brain glioma
Diagnosis of brain glioma
Treatment of brain glioma
Prognosis of brain glioma
Glioma of the brain
It is possible to diagnose a brain glioma based on the results of an MRI scan, as well as other morphological studies that help identify a tumor in the thickness of the tissue. Research by means of Echo-EG or EEG is also effective.
In addition, an additional study may be prescribed:
ophthalmoscopy;
angiography of cerebral vessels;
PAT;
scintigraphy;
examination of cerebrospinal fluid.
As for the classical treatment option, it is, first of all, surgical intervention followed by radiation and chemotherapy, as well as stereotactic radiosurgery.
Glioma of the brain is diagnosed in 60-62% of cases of brain-related oncological diseases. The very name “glioma” originates from the name of the glial tissue from which it develops. Glial tissue surrounds the neurons, ensuring their normal operation.
What is a glioma of the brain
In its structure, glioma resembles an intracerebral formation in the hemisphere of the brain. In appearance, it is pink or gray-white, sometimes has a dark red hue with implicit outlines. Glioma can concentrate even in the walls of the cerebral ventricle, as well as in the chiasmal region, then the glioma is called a chiasmal glioma.
It is very rare for glioma to spread to nerve trunks. This type of glioma is called optic nerve glioma. The progression of glioma growth in the form of germination into the meninges or skull bone is characteristic only in exceptional cases.
As for the shape of the brain glioma, it is most often represented by a fusiform shape, and its size is at least 3 mm. The largest glioma is considered to be an apple-sized tumor.
Most often, the gliomagolic brain develops slowly, without metastases. Nevertheless, it has a pronounced infiltrative growth, which is why it is not always possible to determine where the tumor ends and healthy tissue begins. Most often, the processes of degeneration of the surrounding glioma tissues occur in parallel with the growth of the tumor. This leads to a mismatch between the severity of neurological deficit and the size of the tumor.
Classification of brain gliomas
There are three main types of brain gliomas:
astrocytes;
ependymocytes;
oligodendrogliocytes.
Depending on the type of cells from which the development of brain glioma begins, they talk about astrocytoma (50% of cases of all gliomas), ependymoma (no more than 8% of the total number of cases of the disease) and oligodendroglioma (about 10% of cases).
In practice, there are also mixed types of gliomas, as well as various types of tumors based on the vascular plexus. They may be of unclear origin.
In neurology , there are 4 degrees of malignant glioma of the brain:
Slow-growing benign glioma (for example, juvenile or giant cell astrocytomas);
Borderline glioma is a malignant tumor characterized by slow growth. Malignancy of this degree can be determined only by one sign — by cellular atypia. It is such a glioma that is transformed into the third and fourth degree.
The third degree of malignancy is represented by two signs: the figure of mitosis, microproliferation (or alternatively, nuclear atypia).
The fourth degree of malignancy is characterized by necrosis in the form of glioblastoma multiforme.
If we classify gliomas by localization, then they say about:
subtentorial (located below the cerebellum);
supratentorial (located higher from the place of the cerebellum).
Symptoms of brain glioma
Glioma of the brain can have different symptoms, which depends primarily on the localization of the tumor. Common symptoms are common:
headaches that do not go away even after taking strong painkillers;
feeling of heaviness in the area of the eyeballs;
vomiting;
nausea;
convulsions.
This symptomatology acquires a characteristic vivid severity in the case of glioma germination along the cerebrospinal tract or into the ventricular cavity. When cerebrospinal fluid circulation is disrupted, its outflow occurs, which leads to hydrocephalus with a further increase in intracranial pressure.
Among other symptoms of glioma of the brain:
vestibular ataxia, implying a violation of the coordination of movement when walking, dizziness of a systemic type;
visual impairment;
slurred speech;
decreased muscle activity;
occurrence of paresis, paralysis;
decreased sensitivity (superficial and deep types);
mental abnormalities (decreased muscle activity, memory impairment).
Diagnosis of brain glioma
Diagnosis of glioma of the brain begins with the collection of anamnesis. The patient will learn about his complaints, establish the causes of their occurrence.
Next, a neurological examination takes place, which helps to determine the presence or absence of a sensitivity disorder, as well as to establish a violation of coordination. Diagnosis involves an assessment of muscle strength and its tone, as well as checking reflexes. Specialists also pay attention to the analysis of the state of the mnestic (or mental) sphere of human activity.
Diagnosis by a neurologist includes checking the state of the neuromuscular system. To do this, the doctor uses various instrumental methods, including electromyography or electroneurography.
In order to detect hydrocephalus or displacement of areas of the mid-brain structures, echoencephalography is usually prescribed.
In case of visual disturbances, the doctor directs the patient to an ophthalmologist to conduct a comprehensive ophthalmological examination (visiometry, ophthalmoscopy, perimetry, convergence study).
EEG is prescribed if the patient has a convulsive syndrome.
Differentiated diagnosis of brain glioma should be carried out with intracerebral hematoma, epilepsy, brain abscess, CNS tumors (including germinomas, ganglioneuromas, hemangioblastomas and others). Brain glioma should also be differentiated from the consequence of ischemic stroke.
The most common method of diagnosing brain glioma is MRI, an alternative to which can be CT of the brain, MSCT or angiography of cerebral vessels.
Diagnosis by scintigraphy is also possible.
A brain PET prescribed by a doctor allows you to get information about metabolic processes, which will help to conclude how quickly the tumor grows and how aggressive the nature of its growth is.
A lumbar puncture may also be prescribed.
Analysis of the collected cerebrospinal fluid will help to detect atypical cells.
All of these methods are non—invasive. They help to identify the tumor, but it is possible to make an accurate diagnosis of brain glioma with an indication of its type and malignancy only on the basis of the results obtained by microscopic examination of the thickness of the tumor tissue. The latter is possible only in the case of surgical intervention or biopsy (stereotactic type).
Treatment of brain glioma
Surgical treatment
Treatment of brain glioma involves surgical intervention. However, it is almost impossible to remove the glioma completely (only if it is benign). The final removal of glioma is impossible due to the properties of its infiltration and germination into nearby tissues. During the development of medical technologies, namely the improvement of microsurgery, MRI and intraoperative mapping, there was a push towards the effectiveness of treatment. Nevertheless, for the most part, the treatment of glioma is a traditional resection of the tumor.
Surgical treatment of brain glioma is contraindicated in the case of extremely poor and unstable condition of the patient, as well as in the presence of additional malignant tumors. If glioma spreads to both hemispheres, then its treatment will be inoperable.
Chemotherapy
Glioma of the brain belongs to the category of chemosensitive neoplasms, that is, those that are amenable to chemotherapy, therefore its conduct is mandatory. An interesting fact is that chemotherapy is prescribed, both in the case of operable glioma, and in the case of inoperable. Chemo- or radiation therapy is prescribed as preoperative or postoperative therapy.
If we talk about preoperative chemotherapy (or radiation therapy), then it is carried out only if this diagnosis is confirmed, which can be done based on the results of the biopsy.
Radiosurgery
In parallel with the traditional method of treatment, stereotactic radiosurgery is also carried out, which helps to influence the tumor even with the smallest irradiation.
However, it should always be remembered that neither radiation therapy nor chemotherapy can be a substitute for surgical intervention, since the glioma in its central part has a special area that does not respond well to radiation.
Prognosis of brain glioma
The outcome of brain glioma is unfavorable. With partial removal, a relapse often occurs, so the surgical operation does not cure, but only prolongs the patient’s life. In the case of a high degree of malignancy of glioma, patients die during the next year of the disease. The survival rate is only 25% of all cases. The most favorable outcome has a glioma of the first degree. If the surgeon manages to carry out its complete removal, then about 80% of patients live for more than 5 years.
