Intracranial tumor, or brain cancer, is one of the common diseases in the nervous system, which is very harmful to the function of human nervous system. It is generally divided into two categories: primary and secondary. Primary intracranial tumors can occur in brain tissue, meninges, cranial nerves, pituitary gland, vascular remnants of embryonic tissue, etc. Secondary tumors refer to metastases formed by malignant tumors metastasizing or invading into the skull from other parts of the body.
In recent years, the incidence of intracranial tumors is on the rise. According to statistics, brain cancer accounts for about 5% of the whole body tumors and 70% of childhood tumors, while other malignant tumors will eventually have 20-30% transferred into the cranium. 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, with slightly more men than women.
The etiology and mechanism of brain cancer: According to traditional Chinese medicine, the formation of brain tumor is due to the internal injury to the seven emotions, which causes the dysfunction of internal organs, coupled with the invasion of external evil, cold and heat, and the internal stoppage of phlegm and turbidity, which is gathered in one part of the body for a long time. Experts, after studying the best of all schools of thought, summarized the causes of brain tumor as two kinds of internal and external factors, namely internal is the quality factor or susceptibility factor, external is the triggering factor or contributing factor, but one will not develop. He believes that brain tumor belongs to the category of “headache” and “head wind” in Chinese medicine, and its causes are mainly due to kidney deficiency, loss of nourishment of the medulla, liver and kidney homologation, kidney deficiency and liver deficiency, internal movement of liver wind, evil toxins disturbing the clear orifices, phlegm clouding and blocking the brain, blood and qi stagnation. If the head is the meeting of all the yang, it is the master of the human mind, so it is not allowed to be offended by evil. If the head is affected by the six evil spirits, the brain orifices are directly hit by the evil spirits, or if the evil spirits are guest in the upper jiao, the gasification is unfavorable, the meridians are blocked, the stagnant blood and stagnant turbidity are stopped inside, and all the evil spirits inside and outside are offended in the brain, and they stay and form lumps, and the brain tumor develops. Research on molecular biology of tumor shows that there are two types of genes closely related to the occurrence and development of tumor. One category is oncogene and the other category is anti-tumor gene. The activation and transitional expression of anti-tumor genes induce tumor formation, and the presence and expression of anti-tumor genes help to inhibit tumor development. Oncogenes can exist in normal cells without expressing tumor traits. When such cells are subjected to tumorigenic factors, such as viruses, chemical tumorigenesis and radiation, the tumor genes in the cells are activated, the phenotype of the cells is changed, tumor traits are expressed, and these cells expand rapidly, thus forming a real tumor entity. It is currently believed that the factors that induce tumorigenesis are: genetic factors, physical factors chemical factors and tumorigenic viruses.
Glioma occurs in the cerebral hemisphere, pituitary tumor in the saddle area, auditory neuroma in the pontocerebellar horn, vascular reticulocytoma in the cerebellar sphere, and medulloblastoma in the cerebellar earth.
The clinical manifestations of intracranial tumors: depending on the type of pathology, location 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, persistent headache with paroxysmal intensification, often heavier in the morning, intermittent periods 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: mostly manifested as slow reaction, lazy life, near memory loss or even loss, and in serious cases, loss of self-knowledge and judgment, also manifested as irritable, easily agitated or euphoric.
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 can be preceded by abnormal sensations such as limb numbness.
3. Symptoms of cone bundle damage: manifested as hemiplegia or single limb weakness or paralysis with positive pathological signs on the opposite side of the tumor.
4.Sensory impairment: It shows the impairment of position perception, two-point discrimination perception, graphic perception, material perception and solid perception 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 pterionic 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 shows impotence, libido loss. Women exhibit prolonged menstruation or amenorrhea, and overproduction of growth hormone can lead to gigantism before maturity, and acromegaly after maturity.
(3) Clinical symptoms of pineal area tumor.
1. Symptoms of tetraspanic 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 signs on both sides; uveitis, drowsiness, obesity, general developmental arrest, and precocious puberty 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 hypotonia or no tension on the affected side, blunted knee tendon reflex, horizontal nystagmus, sometimes vertical or rotational tremor may also appear.
2. Cerebellar earthworm symptoms: The main manifestations are trunk and lower limb distal ataxia, excessive separation of the two feet when walking, staggering gait, or swaying from side to side like a drunkard.
(3) Brainstem symptoms: The characteristic clinical manifestation is the appearance of crossed paralysis, such as midbrain lesions, manifesting as oculomotor nerve paralysis on the side of the lesion, pontocerebellar lesions, which can manifest as eye abduction and facial muscle paralysis on the side of the lesion, ipsilateral facial sensory impairment and auditory impairment, and medulla oblongata lesions, which can manifest 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.
(c) Progressive course. Early stage of tumor may not show compression symptoms, but with the increase of tumor, clinical symptoms of different degrees of compression are often manifested, and depending on the growth site and malignancy of tumor, the speed of tumor growth varies, and the degree of symptom progression also varies.
Treatment of brain cancer.
But most of them are difficult to be cured. Malignant tumors have a short course and develop fast, depending on the degree of malignancy, the amount of surgical resection or sensitivity of radiotherapy, recurrence is early and late, and tumors growing in important parts such as brainstem and thalamus are difficult or inoperable. The average survival rate of intracranial malignant tumors is less than one year after surgery for radiation and chemotherapy, and for benign tumors such as glioma, pituitary tumor, craniopharyngioma and cholesteatoma. It is not easy to remove benign intracranial tumors, and gamma knife, X-ray knife and radiation therapy cannot kill the tumors completely, so most patients will still have recurrence after surgery.