Overview
Gliomas are primary tumors that originate in brain parenchyma. Symptoms and diagnosis are similar to those of other brain tumors. Treatment involves surgical excision, radiation therapy, and, for some tumors, chemotherapy. Excision rarely cures.
Gliomas include astrocytomas, oligodendrogliomas, medulloblastomas, and ependymomas. Many gliomas infiltrate brain tissue diffusely and irregularly.
Astrocytomas are the most common gliomas. They are classified, in ascending order of malignancy, as
- Grade 1 or 2: Low-grade astrocytomas
- Grade 3: Anaplastic astrocytomas
- Grade 4: Glioblastomas, including glioblastoma multiforme, the most malignant
Cause
The cause is still unknown. Researchers have not found any direct genetic link. Children irradiated for tinea capitis have been found to have an increased risk for other central nervous system tumors, such as meningiomas, gliomas, and nerve sheath tumors, but not necessarily tumors of the brain stem.Signs And Symptoms
Common symptoms include, but are not necessarily limited to: -- Lack of facial control, (droopy eyelids)
- Double vision
- Headache or headache that gets better after vomiting
- Nausea and vomiting
- Weakness and fatigue
- Seizures
- Balance problems
Symptoms can develop slowly and subtly and may go unnoticed for months. In other cases, the symptoms may arise abruptly. A sudden onset of symptoms tends to occur with more rapidly growing, high-grade tumors.
Diagnosis
When a patient shows symptoms of glioma, doctors perform a thorough neurological exam to check vision, hearing, balance, coordination and reflexes. The physician then orders imaging tests to further localize the problem.Test results are generally available to the neurologist within a day in Mayo's state-of-the-art electronic medical record. Skilled neuro-pathologists also review the test results, and then examine tumor tissue to diagnose the specific type of tumor present.
Treatment Options
AstrocytomasAstrocytomas are the most common glioma, and can occur in most parts of the brain (and occasionally in the spinal cord). Astrocytomas originate from cells called astrocytes and are most commonly found in the main part of the brain, the cerebrum. People can develop astrocytomas at any age, though they are more common in adults. Astrocytomas in the base of the brain are more common in young people.
Ependymomas
These tumors begin in the ependyma, the cells that line the passageways in the brain where special fluid that protects the brain and spinal cord (cerebrospinal fluid) is made and stored. They are a rare glioma and can be found anywhere in the brain or spine. Most commonly they arise in the cerebrum, the main part of the brain. Ependymomas may spread from the brain to the spinal cord via cerebrospinal fluid.
Glioblastoma Multiforme
Glioblastoma multiforme (grade IV astrocytoma) is the most common and most malignant of the primary brain tumors. Glioblastoma multiforme usually spreads quickly to other parts of the brain. For this reason, these tumors are difficult to treat. It is not uncommon for them to recur after initial treatment.
Oligodendrogliomas
These primary brain tumors begin in brain cells called oligodendrocytes, which support and nourish the cells that transmit nerve impulses. This tumor is normally found in the cerebrum, the main part of the brain. Oligodendrogliomas are more common in adult men than women, and can occur in children.
Mixed Gliomas
Mixed gliomas are brain tumors that have more than one type of brain cell, including astrocytes, ependymal cells and/or oligodendrocytes. The most common site for a mixed glioma is the cerebrum, the main part of the brain. Like other gliomas, it can spread to other parts of the brain. Mixed gliomas are more common in adult men than women, and can occur in children.
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