Brain gliomas

Gliomas are intracranial tumors. They come from their own brain tissue, so they are also referred to as intrinsic. It is one of the most important CNS tumors due to its frequent occurrence. A typical picture is a hemispherical tumor growing infiltratively. Even with a relatively large size, it does not disrupt brain tissue. The length of the symptom history is "inversely proportional" to the malignancy.

Classification
Tumors of the brain parenchyma are referred to as intrinsic. The vast majority are gliomas (tumors of the glia). Tumors from neurons are rare because neurons do not divide after birth (just during the division of the cell, its malignant transformation can occur) and create the permanent structure necessary to preserve memory traces.

Gliomas are divided into:


 * 1) astrocytoma
 * 2) oligodendroglioma
 * 3) ependymoma
 * 4) gangliogliomaMRI - WHO grade I ependymoma

Clinical manifestations
Gliomas (and intracranial tumors in general) are accompanied by a typical triad of symptoms:


 * 1) focal neurological deficit
 * 2) intracranial hypertension syndrome
 * 3) secondary seizures

Focal neurological deficit
Focal neurological deficits are extinct neurological symptoms that vary according to the location of the tumor. These are paresis, visual field disorders, mental alterations, disorders of symbolic functions (aphasia , dyscalculia), cerebellar symptoms, cranial nerve disorders.

Causes of focal neurological findings:


 * 1) direct damage to brain tissue by tumor (permanent)
 * 2) peritumorous edema (reversible)
 * 3) local compression (not always reversible)

Intracranial hypertension
Causes of intracranial hypertension in intracranial tumors:


 * 1) own tumor volume
 * 2) peritumorous edema
 * 3) cerebrospinal fluid obstruction ( in cranial fossa tumors)

Secondary seizures
Secondary seizures are irritant focal symptoms. Epileptogenic focus is due to partial damage to neurons at the tumor site. This so-called secondary epilepsy, having an organic cause, is also referred to as lesional epilepsy. Epilepsy is more common if the tumor grows to a specific location. Patients with tumors damaging the sensitive or motor gyrus are most likely to develop epilepsy and mediotemporal structures. It also depends on the individual's emergency, ie each individual has a different predisposition to epilepsy. Initially, localized seizures (Jackson's epilepsy) appear, later generalized (grand mal), where the patient is threatened with life by brain hypoxia and subsequent accentuation of edema around the lesion. An epileptic seizure can often be the first sign of an intracranial tumor.

Astrocytoma
Astrocytoma is the most common of the glial intracranial tumors, although it can also occur in the spinal cord (especially in children)1. Both benign and malignant forms are known. Astrocyte tumors have a typical tendency to degenerate from more benign to more malignant forms - so benign astrocytomas are often diagnosed in younger patients and, conversely, malignant in older patients2

Oligodendroglioma
Oligodendroglioma is in most cases a benign tumor, but there are also semi-minimal forms. It typically affects adult patients, the most common location being the frontal lobe3. The prognosis is more favorable compared to astrocytomas, although the probability of recurrence is still very high 4 .

Ependymoma
More detailed information can be found on the Ependymom page .

It is a tumor with a relatively diverse biological behavior, there are both benign and malignant forms. Most often, ependymomas grow intracranially in the ventricular system (especially ventricular IV ), but it can also occur in the spinal cord (they represent 60% of all spinal intramedullary tumors). Intracranial ependymomas are prevalent in children, whereas spinal ependymomas are prevalent in adult patientss5 6.

Ganglioglioma
Ganglioglioma is a rare CNS tumor, most often located in the temporal lobe 7  . It is not purely glioma - it consists of glial and neuronal (ganglional) cells, while the proportions of its components differ in individual patients. In the vast majority of cases, it is a low-grade tumor, although there is also an anaplastic form with highly aggressive behavior and an unfavorable prognosis 8. It mainly affects younger patient 9 .

related articles

 * Meningeoma
 * Astrocytoma
 * Glioblastoma
 * Oligodendroglioma
 * Ependymoma
 * Schwannom
 * Vestibular schwannoma
 * Spinal tumors
 * CNS tumors (pediatrics)

Source

 * BENEŠ, Jiří. Study materials  [online]. © 2007. [feeling. 2009]. < http://www.jirben.wz.cz/ >.

Reference

 * 1) ↑ KEPES, JJ, CM STRIEBINGER and CE BRACKETT. Gliomas (astrocytomas) of the brain-stem with spinal intra- and extradural metastases: report of three cases ..  Journal of Neurology, Neurosurgery & Psychiatry. 1976, vol. 1, vol 39, pp. 66-76, ISSN 0022-3050. DOI: 10.1136 / jnnp.39.1.66.
 * 2) ↑ ROBINSON, Clifford G., Richard A. PRAYSON and Joseph F. HAHN. Long-term survival and functional status of patients with low-grade astrocytoma of spinal cord. International Journal of Radiation Oncology * Biology * Physics. 2005, vol. 1, vol 63, pp. 91-100, ISSN 0360-3016. DOI: 10.1016 / j.ijrobp.2005.01.009.
 * 3) ↑ JOHNSON, DR, FE DIEHN and C. GIANNINI. Genetically Defined Oligodendroglioma Is Characterized by Indistinct Tumor Borders at MRI. American Journal of Neuroradiology. 2017, year. 4, vol 38, pp. 678-684, ISSN 0195-6108. DOI: 10.3174 / ajnr.a5070.
 * 4) ↑ OHGAKI, Hiroko and Paul KLEIHUES. Population-Based Studies on Incidence, Survival Rates, and Genetic Alterations in Astrocytic and Oligodendroglial Gliomas. Journal of Neuropathology & Experimental Neurology. 2005, vol. 6, vol 64, pp. 479-489, ISSN 0022-3069. DOI: 10.1093 / jnen / 64.6.479.
 * 5) ↑ MALDJIAN, Joseph A. and Rita S. PATEL. Cerebral neoplasms in adults. Seminars in Roentgenology. 1999, vol. 2, vol. 34, pp. 102-122, ISSN 0037-198X. DOI: 10.1016 / s0037-198x (99) 80025-x.
 * 6) ↑ CHAMBERLAIN, Marc C .. Ependymomas. Current Neurology and Neuroscience Reports. 2003, vol. 3, vol. 3, pp. 193-199, ISSN 1528-4042. DOI: 10.1007 / s11910-003-0078-x.
 * 7) ↑ RUMBOLDT, Zoran, Mauricio CASTILLO and Benjamin HUANG, et al. Brain Imaging with MRI and CT: An Image Pattern Approach. - edition. Cambridge University Press, 2012. 433 pp.  ISBN 9781139576390.
 * 8) ↑ SONG, Jye Young, Jeong Hoon KIM and Young Hyun CHO. Treatment and Outcomes for Gangliogliomas: A Single-Center Review of 16 Patients. Brain Tumor Research and Treatment. 2014, vol. 2, vol. 2, pp. 49, ISSN 2288-2405. DOI: 10.14791 / btrt.2.2.4.49.
 * 9) ↑ LOUIS, David, Hiroko OHGAKI and Otmar WIESTLER, et al. WHO Classification of Tumors of the Central Nervous System. - edition. International Agency for Research on Cancer, 2016. 408 pp.  ISBN 9789283244929.