Oncological diseases are extremely serious problems. This is especially true for those types of pathologies that affect the parts of the brain. In the article we will touch on one of these types of lesions - a tumor of the cerebellum. We will analyze in detail the symptoms of the disease, its characteristics, types of diagnosis and treatment.
What is this?
A tumor of the cerebellum is any benign or malignant formation localized in this part of the brain. This is a pathology of both primary and secondary (metastatic) nature. Its symptoms are variable, they are conditionally divided into three categories - cerebellar, stem and brain.
The main direction of diagnostics is magnetic resonance imaging of the cerebral system. The final diagnosis is made only on the basis of the results of a histological examination of the formation sample.
The main direction of treatment of a tumor of the cerebellum is surgical. The therapy is aimed at radical elimination of the formation, restoration of the circulation of cranial fluids, release of the brain stem from pathological compression.
If we look at the statistics, tumorscerebellum will make up 30% of the total mass of neoplasms developing in the brain. Today, more than a hundred of its (tumor) morphological forms are known. At the same time, it is said that glioma will act as a cerebellar tumor in 70% of cases.
This pathology can affect a person at any age. However, some regularities are also noted. Medulloblastomas occur mainly in children. Astrocytomas, hemangioblastomas - in middle-aged people. Glioblastomas and metastatic formations are common in older people.
The tumor most often affects men, as well as Caucasian patients.
Causes for the development of pathology
Today, experts cannot accurately identify the etiological factors that provoke the development of a cerebellar tumor. Among the possible causes, the following are primarily identified:
- Heredity (a factor that affects 10% of patients).
- History of radioactive exposure.
- Exposure to oncoviruses - herpes, human papillomavirus, adenoviruses, etc.
- Effect on the body of chemical carcinogenic drugs.
- HIV infection, AIDS.
- Immunosuppressive therapy.
General symptoms
First of all, a tumor of the cerebellum will be characterized by a general incoordination of movements, orientation in space. This is due to the main function of this part of the brain - the coordination of both speech and movements. We will present the general symptoms of a cerebellar tumor below.
Vomiting, nausea, headache. Datasigns are characteristic of both the early and late stages of neoplasm development. Growing, the tumor begins to block the fluid surrounding the brain. Such a harmful effect leads to the development of hydrocephalus (enlargement, swelling of the cranium), an increased content of the liquid mass inside the skull.
Causes nausea and headache increased intracranial pressure. Painful syndrome is strongly manifested in the morning, after waking up. It can be so intense that it causes vomiting. As the day progresses, the pain subsides. Conventional migraine medications do not provide relief.
Disordered gait. It is the cerebellum that controls muscle coordination. Growing, creating increased intracranial pressure, the tumor interferes with the brain department to properly perform its functions. The result is the patient's clumsiness, impaired coordination of his movements. The gait also changes greatly. With this cancer, she is shaky and swaying.
Consequences of damage to the cranial nerves. Let's turn to anatomy. The cranial fossa in humans is characterized by a very small volume. A tumor of the cerebellum can completely occupy this space, damaging adjacent structures. Most often they are cranial nerves. Their injury leads to the following:
- Loss of peripheral vision.
- Permanently dilated pupils.
- Blurry "picture".
- Pupil deviation from normal position.
- Weakened facial muscles.
- Violation of taste perception.
- Losshearing.
- Loss of sensation in some areas of the face.
Varieties of oncological lesions of the cerebellum
Tumor of the cerebellum of the brain is primarily divided into the following varieties:
- Cancer formation metastasizing to the cerebellum. For example, such a phenomenon is sometimes observed in cancer of the lungs, mammary glands.
- Cancer formation that originally began to develop in the cerebellum. These include astrocytoma and medulloblastoma.
Let's take a closer look at the classification of a brain tumor of the cerebellum according to its varieties:
- Gangliocytoma dysplastic.
- Hemangioblastoma.
- Medulloblastoma.
- Astrocytoma.
Next, we will analyze the specific symptoms of a cerebellar tumor of the types presented.
Malignant and benign formations
Cerebellar tumors are divided into two large groups:
- Benign formations. Infiltrative growing astrocytomas, as well as locally developing hemangioblastomas. They manifest themselves in the form of a cystic formation (a small node with a nearby cystic cavity).
- Malignant formations. The most obvious example is medulloblastoma. It is distinguished by a rapid rate of progression, it can easily grow in subarachnoid spaces. In second place is cerebellar sarcoma.
Astrocytoma
The name is given by the origin of the neoplasm - astrocytes located in the cerebellum. This tumor is characterized by slow growth. It rarely spreads to other areas of the brain. But cases of metastasis, even rare ones, still take place.
Symptoms of this type of cerebellar tumor are as follows:
- Morning sickness, morning and night migraines. The manifestation is systematically repeated for several weeks or months.
- May develop ataxia and dysdiadochokinesia with appropriate damage to the cerebellum. These signs help specialists determine the location of the tumor.
- Nausea, often ending in vomiting.
- Apathy.
- Loss of orientation in space.
- Confused thinking.
- Weakness in limbs, numbness in arms and legs.
- Deterioration of visual function. The "picture" doubles or blurs.
- Blurred consciousness.
- Memory problems.
- Difficult, confused speech.
Medulloblastoma
First of all, we note the features of the development of this cerebellar tumor in children. Symptoms in young children in most cases are mild. Limited to the following:
- Changing habitual behavior.
- Slight increase in head circumference.
- Sleepiness and apathy.
- Vomiting. This syndrome is more common in older children than in infants.
When examining a small patient, a specialist can reveal an anterior protruding fontanel, as well as a divergence of the bones of the skull. Older children often present with statistical ataxia,abnormal head tilt, altered gait. What does it say? An abnormal tilt of the head indicates both paralysis of the trochlear nerve and the growth of the neoplasm to the foramen magnum. A potential threat to the life of the patient is the protrusion of the cerebellar tonsils into this opening. This happens due to the same pressure of the tumor on the brain.
Medulloblastoma is characterized by the rapid development of the clinical picture. Therefore, specialists can diagnose the disease by symptoms in less than two months.
One of the obvious manifestations of this oncological pathology in patients who have come out of their infancy will be severe migraines and vomiting in the morning. Symptoms are caused by increased intracranial pressure. As we said above, it is caused by the blockade of the rapidly growing tumor of the cranial fluids.
Examination of the fundus will also speak of increased intracranial pressure - swelling of the optic nerve is visible. This fact is accompanied by the patient's complaints of visual impairment. However, it will not be too pronounced. In some patients, paralysis of the fourth or sixth cranial nerve is additionally detected. There are also complaints of diplopia. It is also caused by pressure from the neoplasm. Some patients with medulloblastoma are diagnosed with speech disorders.
In most cases, the tumor affects the median structures of the brain. This causes gait disturbance, torso ataxia, nystagmus. Sometimes there is a violation of the letter, general clumsiness.
WhatFor adult patients, their medulloblastoma may be characterized by a unilateral manifestation. A common example is dysmetria.
Hemangioblastoma
A rather rare type of cancer that affects the blood vessels of the brain. Such neoplasms can be localized in all areas of its spheres. However, it is most often found in the cerebellum, the cranial posterior fossa.
According to their characteristics, hemangioblastomas are benign neoplasms. However, anatomically, they are located so close to the vital structures of the brain that the slightest damage to the latter leads to serious dysfunctions. Typical localization is the soft shell surrounding the brain.
Hemangioblastoma manifests itself as follows:
- Headaches.
- Nausea and vomiting.
- Changed gait.
- Double vision.
- Decrease in visual acuity.
- Recurring dizziness.
- Mental, personality changes.
- Feeling of discomfort in the neck area.
- Anorexia.
- Apathy, lethargy.
- Noises in the head.
- Chronic feeling of weakness in limbs.
- Faints.
- Speech impairment.
- Eye pain.
The listed symptoms can appear both sharply and smoothly. The aggravation of the severity of the patient's condition most often indicates bleeding or increased intracranial pressure. Sometimes the tumor may manifest itselfsubarachnoid hemorrhage.
Hemangioblastomas are rarely diagnosed in young patients. Basically, people 20-40 years old are subject to them. Men are twice as likely to be diagnosed with cancer.
Gangliocytoma dysplastic
Belongs to the category of benign neoplasms. The appearance of gangliocytoma causes abnormal development of the cerebellar cortex. The symptoms of this lesion are as follows:
- Dizziness.
- Migraine.
- Nausea and vomiting.
- Macrocephaly.
Less patients have seizures, subarachnoid hemorrhage, orthostatic hypotension.
Often seen in patients diagnosed with Cowden's syndrome. Pathology is complicated by diseases of the thyroid gland, oral papillomatosis, meningiomas, the formation of polyps in the organs of the digestive tract, and so on.
Diagnosis
Examination of the patient begins with a visual examination by a neurologist for external specific signs of pathology. Next, an ophthalmoscopy is performed - an examination of the fundus. The procedure allows you to assess the condition of the optic nerve, which is often affected by tumors of the cerebellum.
Mandatory magnetic resonance or computed tomography of the brain. It reveals the presence of education, its location and size. Magnetic resonance cerebral angiography is additionally performed to rule out tumor damage to the vessels.
Treatment of pathology
As we mentioned, the mainmethod of treatment - surgical. This is a radical excision of education. But if it grows into the fourth ventricle, complex anatomical structures, then this makes it difficult to remove a cerebellar tumor. Then, to restore normal CSF circulation, the maximum possible amount of pathogenic tissue is cut out.
Surgery on a tumor of the cerebellum is also a partial resection of the opening of the occipital bones, the first cervical vertebra. These manipulations help reduce the pressure of education on the brain stem.
To reduce hydrocephalus, with its sharp development, shunting measures, external ventricular drainage, and cerebral ventricular puncture are also indicated.
After removal of the tumor, its matter is sent for histological analysis to determine the malignancy, stage of development.
In addition, the patient is prescribed chemotherapy and radiation therapy, taking sedatives, antiemetics, painkillers.
Forecasts
As for the prognosis for a cerebellar tumor, the results of treatment depend on the stage of its development, size. If this is a benign formation, completely removed during surgery, then the prognosis is favorable. When the benign matter is not completely excised, after a while there is a relapse, a second operation is required.
What are the consequences of a cerebellar tumor? Without treatment, the patient dies from the fact that she pinches the respiratory and cardiovascular centers of the stem structures. The prognosis for malignant tumors is unfavorable. The life expectancy of patients aftersurgery and ancillary therapy - 1-5 years.
Tumor of the cerebellum is a serious pathology, the specific causes of which have not been elucidated. So far, medicine can only deal with benign such formations.
