Tumours of the brain stem - neoplasms that are located in the midbrain and / or medulla oblongata, the bridge. It should be noted right away that such structures can be both benign and malignant. In any case, the formation and growth of the tumor is accompanied by the appearance of various neurological disorders. According to statistics, the disease in most cases is diagnosed in the later stages of development and is difficult to treat.
Of course, many people are looking for more information. Why does pathology develop? What are the symptoms of a brain stem tumor? Are there effective therapies? What predictions can you expect? The answers to these questions are worth reading.
Causes of tumor formation
Why does a brainstem tumor form?The reasons, unfortunately, are not always clear, because the mechanisms of the development of cancer are not fully understood. Scientists have identified some risk factors.
- There is a genetic inheritance. According to statistics, most often, patients with a tumor of the brain stem had relatives with certain cancers.
- Risk factors also include some genetic diseases, in particular, tuberous sclerosis, Turco's syndrome, Recklinghausen's disease, Gorlin's syndrome, etc. The presence of such pathologies increases the likelihood of developing brain cancer.
- Long-term exposure to chemicals such as mercury, arsenic, and lead are potentially hazardous.
- There are certain age groups at risk - children aged 5 to 7 years old, as well as older people 65-70 years old are at risk.
Of course, bad ecology, unhe althy diet, bad habits, weakened immune system contribute to the development of cancer, but only if there are prerequisites.
Classification depending on the type of neoplasm growth
Of course, today there are many classification schemes for this disease. During the diagnosis, doctors pay attention primarily to the type of tumor growth. Depending on this, three main forms are distinguished.
- A nodular tumor of the brain stem is a neoplasm resembling a node. It is surrounded by a dense capsule and has smooth edges. Often such a tumor has a cystic part. By the way, if the structure is benign,it can be removed surgically.
- The diffuse form is much more dangerous. Such a structure does not have clear boundaries, it grows into nearby areas, replacing he althy cells. To remove it, while avoiding serious damage to the brain, is almost impossible. Unfortunately, in 80% of cases, patients have a diffuse tumor of the brain stem. In children, such an ailment is diagnosed relatively often.
- Infiltrative neoplasm is the most rare. In this case, the tumor is also surrounded by a capsule and has clear edges. On microscopic examination, it can be seen that the nerve tissue adjacent to the neoplasm is gradually destroyed.
Tumor of the brain stem: photos and main types of neoplasms
We have already considered the types of growth of benign and malignant neoplasms. But if we talk about tumors of the brain stem, it is worth noting that there are several varieties.
- Astrocytomas are diagnosed in 60% of patients with this disease. Fibrillar and pilocytic neoplasms are benign. But multiforme and anaplastic astrocytomas are malignant, characterized by rapid growth and the formation of metastases.
- Oligodendrogliomas are less common - about 8% of cases. Such neoplasms grow slowly and often reach large sizes.
- Ependymomas are diagnosed in 5% of cases, often with a similar form of cancerchildren face. In 70%, this neoplasm is benign. Against the background of the course of the disease, an increase in intracranial pressure and the development of hydrocephalus are often observed.
It is worth noting that the choice of treatment technique directly depends on the type and type of tumor growth. In this case, a thorough diagnosis is very important.
Stages of disease progression
A tumor of the brain stem, like almost any other neoplasm, grows and develops in several stages.
- The first stage is accompanied by the formation of a small tumor - its diameter does not exceed three centimeters. It has clear edges and does not extend to nearby tissues. Unfortunately, this stage is rarely accompanied by any symptoms, so the disease is rarely diagnosed at the first stage.
- The second stage is characterized by the growth of the neoplasm - its size already exceeds 3 cm. Nevertheless, the tumor retains clear edges. The first symptoms appear, but patients very often write off everything as a common ailment.
- In the third stage, the tumor grows into nearby structures, such as the ventricles of the brain.
- The fourth stage is no longer just a tumor of the brain stem. At this stage, the disease is accompanied by the rapid formation and growth of metastases throughout the body. During this period, the disease is practically untreatable.
Major neurological symptoms
Symptoms of a brainstem tumor can vary. Everybody is heredepends on the exact location of the neoplasm, as well as its size. Often, a growing tumor compresses blood vessels, compresses parts of the brain, and leads to a sharp increase in intracranial pressure. Moreover, a malignant structure located in one part of the brain can negatively affect the work of other parts of the central nervous system.
However, some common symptoms can be identified.
- Most often patients (about 90% of all patients) complain of headaches. Unpleasant sensations can be localized in different areas. The pain is rarely constant - in most cases it is paroxysmal in nature. Sometimes it is aching, moderate, and sometimes sharp, tearing, almost intolerable. Unpleasant sensations often appear in the morning. A headache attack can be triggered by stress, physical activity, coughing, heavy lifting, etc.
- Often, along with headaches, dizziness also appears. Patients often feel dizzy and complain of blackouts and tinnitus.
- In 60% of cases, one of the symptoms is nausea. Attacks are often accompanied by vomiting, and it occurs suddenly and most often in the morning.
- Sometimes you can notice that patients hold their heads in an incorrect, unnatural position. Thus, a person reflexively tries to take a position in which the tumor does not compress the blood vessels, cranial and cervical nerves.
- Quite often (65% of cases) tumor growth is accompanied by mental disorders. Some patientsbecome irritable and nervous, while others, on the contrary, suffer from apathy, slow reaction. There are various changes in consciousness.
- Epileptic seizures may occur.
- Tumor growth affects the work of visual analyzers. About 70% of patients complain of visual impairment, which is associated with increased intracranial pressure and compression of the optic nerves. There is swelling and atrophy of the disc, hemorrhages occur in the peridiscal spaces.
- In later stages, bulbar syndrome may develop. Against the background of squeezing certain parts of the brain, swallowing problems and speech disorders occur.
- If the tumor is actively growing, then a change in the shape of the skull is possible - its walls sometimes become thinner, and the sutures diverge. Similar symptoms are usually observed in children.
Focal symptoms
Some disorders do not appear in all patients. Their development is associated with focal lesions of the brain. These symptoms include:
- decrease in the sensitivity of the hearing organs (sometimes even deafness);
- paresis and twitching of eye muscles;
- motor disorders, in particular problems with coordination, orientation in space, changes in gait;
- violations of visual and tactile perception;
- hand tremor;
- facial disorders associated with facial muscle weakness (e.g. asymmetrical smile);
- frequent and sudden jumps in blood pressure.
It is worth noting that as the tumor grows, the patient's condition worsens - tachycardia, cardiomyopathy, dysphagia, and respiratory failure develop.
Diagnostic measures
In this case, timely and accurate diagnosis is very important.
- First, a general neurological examination and medical history are taken.
- Computer and magnetic resonance imaging are mandatory. In the pictures, the doctor can see the lesions, assess the location and size of the tumor.
- Performed encephalography and echoencephalography. These examinations allow you to evaluate the functioning of the brain, detect an increase in intracranial pressure.
- Angiography of the vessels of the brain is often additionally performed, as well as X-ray of the skull.
Is the operation possible?
Can a brainstem tumor be treated? Is the operation possible? What should the patient expect? These questions are asked by many people.
The task of the surgeon is to remove the tumor while avoiding damage to the nerve tissue. It should be said right away that in most cases such neoplasms are inoperable. If a nodular tumor can be cut out, then it is almost impossible to cope with diffuse neoplasms.
The operation is usually performed endoscopically, using a laser. This procedure is safer, since the laser beam is more precise than a conventional scalpel, and less traumatic to the tissue, allowing you to immediately cauterize damaged vessels.
Sometimescryotherapy is performed - the tumor is treated with liquid nitrogen, which allows the destruction of altered cells.
Other treatments
The operation allows you to remove a large tumor with even, clear edges. But surgery must be complemented by other treatments to kill any remaining malignant cells.
The doctor determines the treatment regimen individually. Many patients benefit from chemotherapy, which involves taking certain combinations of cytotoxic drugs. Radiation therapy is also considered very effective, which involves exposing malignant cells to high doses of radiation.
Symptomatic therapy
Unfortunately, the treatment of a tumor of the brain stem with the methods described above does not always end successfully. On the other hand, the patient's condition can be alleviated with the right drugs.
For example, drugs such as Nurofen, Diclofenac, Prednisolone have anti-inflammatory properties and help to quickly relieve pain and swelling. In the presence of mental disorders, antipsychotics are used, for example, Haloperidol. Carbamazepine and other anticonvulsants help to cope with epileptic seizures. Some patients require antidepressants.
Tumour of the brainstem: prognosis for patients
What kind of prognosis can a patient with such a diagnosis expect?What can say the one who was sick? A brain stem tumor is a dangerous disease. In this case, timely diagnosis and prompt initiation of therapy are extremely important.
Unfortunately, a neoplasm can very rarely be removed surgically. If we are talking about a benign tumor, then it usually grows slowly - a person can live for 10-15 years without the appearance of any serious neurological disorders or symptoms. With malignant structures, the situation is different - most often the disease ends fatally within a few years (and sometimes months) after the first signs appear. Conservative therapy can prolong the life of the patient, but, unfortunately, it does not help to get rid of the tumor.
