I. What is brain tumor
Tumors growing in the skull are commonly called brain tumors, including primary brain tumors that occur in the brain parenchyma and secondary brain tumors that metastasize to the skull from other parts of the body. Primary brain tumors are classified into benign and malignant according to their biological characteristics. Benign brain tumors are slow-growing, with intact envelope, no infiltration of surrounding tissues, and good differentiation; malignant brain tumors are fast-growing, without envelope, with inconspicuous boundaries, infiltrative growth, and poor differentiation. Regardless of benign or malignant, they can squeeze and push normal brain tissues, causing intracranial pressure to rise and threaten human life.
In recent years, the incidence of intracranial tumor is on the rise, according to statistics, intracranial tumor accounts for about 5% of the whole body tumor and 70% of children tumor, while other malignant tumors will eventually have 20-30% transferred into the cranium, due to its infiltrative growth, once in the cranium according to a certain space, regardless of its nature is benign or malignant, it is bound to make the intracranial pressure rise, compressing brain tissue, leading to central nervous damage and endangering patients’ lives. This will lead to central nervous system damage and endanger the life of patients.
Intracranial tumor can occur at any age, but it is most common between 20-50 years old. In children, tumors in the posterior cranial fossa and midline are more common, mainly medulloblastoma, craniopharyngioma and ventricular meningioma. In adults, gliomas in the cerebral hemisphere are most common, such as astrocytoma, glioblastoma, ventricular meningioma, followed by meningioma, pituitary tumor, craniopharyngioma, neurofibroma, cavernous hemangioma, cholesteatoma, etc. There is no significant gender difference in the incidence of primary intracranial tumors, but there are slightly more men than women.
What are the premonitory signs and clinical manifestations of brain tumor?
Depending on the type of pathology, site of occurrence and main speed, there are three common features.
1. Increased intracranial pressure;
2.Limited focal symptoms;
3. Progressive course of the disease.
(a) Symptoms of increased intracranial pressure occur in about 90% or more of brain tumor patients and are manifested as
1.Headache, nausea, vomiting, headache mostly located in the forehead and temporal region, with persistent headache intensifying paroxysmally, often heavier in the morning, intermittent period can be normal.
2. Optic papillar edema and vision loss.
3.Mental and consciousness disorders and other symptoms: dizziness, diplopia, transient black haze, sudden collapse, blurred consciousness, mental agitation or indifference, epilepsy may occur, and even coma.
4, changes in vital signs: moderate and severe acute intracranial pressure increase often causes respiration, pulse, slowing, and blood pressure increase.
(2) Local symptoms and signs: It mainly depends on the site of tumor growth, so the diagnosis of tumor localization can be made according to the patient-specific symptoms and signs.
1.Clinical symptoms of cerebral hemisphere tumor.
(1)Mental symptoms: Most of them are slow reaction, lazy life, near memory loss, even loss of self-knowledge and judgment in severe cases, and also irritability, excitability or euphoria.
(2) Seizures: including generalized grand mal seizures and limited seizures, frontal lobe is the most common, followed by temporal lobe, parietal lobe, occipital lobe is the least common, some cases have aura before convulsions, such as temporal lobe tumor, seizures are often preceded by fantasy, vertigo and other aura, parietal lobe tumor seizures may be preceded by abnormal sensations such as numbness of limbs.
(3) Symptoms of cone bundle damage: manifested as positive pathological signs of hemiplegia or single limb weakness or paralysis contralateral to the tumor.
(4) Sensory impairment: manifesting as position perception, two-point discrimination perception, graphic perception, texture perception and solid perception impairment of the limb contralateral to the tumor.
(5) Aphasia: divided into motor and sensory aphasia.
(6) Visual field changes: manifested as visual field defects and hemianopsia.
2.Clinical manifestations of tumor in pterygoid saddle area.
(1)Visual impairment: the development of tumor to the saddle compressing the optic cross causes vision loss and visual field defect, which is often the main reason for patients with pterygoid saddle tumor to come to the clinic, and fundus examination can find primary optic nerve atrophy.
(2) Endocrine dysfunction: such as hypogonadism, male manifests as impotence and hypersexuality. Women show prolonged menstrual period or amenorrhea. Excessive secretion of growth hormone can lead to gigantism before maturity and acromegaly after maturity.
3.Pineal area tumor clinical symptoms.
(1) Symptoms of tetraspanus compression: concentrated in two aspects, namely: visual impairment, impaired pupillary response to light and regulatory response, tinnitus and deafness; unstable holding, staggering gait, horizontal nystagmus, incomplete paralysis of limbs, cone bundle sign on both sides; uveitis, drowsiness, obesity, general developmental arrest, precocious puberty is seen in males.
4.Clinical symptoms of posterior cranial fossa tumor.
(1) Cerebellar hemisphere symptoms: mainly manifested as ataxia of the affected limb, also may appear as hypotonia or atonia of the affected side, dull knee tendon reflex, horizontal nystagmus and sometimes vertical or rotational nystagmus.
(2) Cerebellar earthworm symptoms: The main symptoms are trunk and lower limb distal ataxia, walking with feet too far apart, staggering gait, or swaying from side to side like a drunken man.
(3) Brainstem symptoms: The characteristic clinical manifestation is the appearance of crossed paralysis, such as midbrain lesions, manifesting as ophthalmic nerve paralysis on the side of the lesion, pontocerebellar lesions, manifesting as eye abduction and facial muscle paralysis on the side of the lesion, ipsilateral facial sensory disturbance and auditory disturbance, and medulla oblongata lesions, manifesting as ipsilateral tongue muscle paralysis, pharyngeal paralysis, and loss of taste sensation in the posterior 1/3 of the tongue.
(4) Cerebellar pontocerebellar horn symptoms: tinnitus, hearing loss, vertigo, facial numbness, facial muscle twitching, facial muscle palsy, hoarseness, water choking, ataxia and horizontal nystagmus on the sick side.
(3) Progressive course, the tumor may not show compression symptoms in the early stage, but with the increase of tumor, it often shows different degrees of compression symptoms clinically, and according to the growth site of tumor and the degree of malignancy, the speed of tumor growth is different, and the degree of symptom progression is also fast and slow.
How to prevent brain tumor
In daily life, you should go for regular medical checkups and pay attention to your body from time to time to see if there are signs of brain tumor, and if there are some reactions, you should find out what causes the discomfort. To confirm whether it is a brain tumor, you need to go to the hospital for specific tests, such as blood test index, CEA, CA125, and MRI.
Diagnosis of brain tumor
Brain tumor can generally be divided into primary brain tumor and metastatic tumor metastasized to the brain from other parts (such as lung, colon, etc.). If magnetic resonance imaging is not suitable, computerized tomography can be performed for preliminary diagnosis. However, both magnetic resonance imaging and computed tomography can only confirm whether there are structural abnormalities in the brain (e.g., whether there is an abnormal mass), but is the mass malignant? Whether it is a primary mass or a metastatic mass can only be determined by “tissue biopsy”. The risk of bleeding and anesthesia is the same all over the world, and there is no guaranteed way to perform a biopsy without bleeding.
V. Treatment methods for brain tumors
Surgery and head gamma knife treatment are the main treatments. Generally, benign tumors can be cured by surgical removal and there is no recurrence. In addition, there are some residues after surgery, such as meningioma in the saddle area, pituitary tumor wrapped around the cavernous sinus part can not be operated, after surgery can be feasible head gamma knife treatment, can achieve the purpose of killing the tumor and cure. However, for malignant tumors, the rate of recurrence after treatment varies according to their malignancy. Glioblastoma and astrocytoma are highly malignant, and most of them will recur within 1 year after surgery, so they often need to be treated with general radiotherapy or gamma knife after surgery to delay the recurrence of the tumor.