Types of brain tumors
The World Health Organization classification takes into account not only the appearance of cells under a microscope, but also the molecular genetic characteristics of the tumor, which determine the prognosis and choice of treatment. The degree of malignancy is designated from 1 to 4. In adults, among primary tumors, meningiomas, gliomas and pituitary adenomas are often found, in children - medulloblastomas and low-grade gliomas. Metastases to the brain are most often caused by lung cancer, breast cancer, and melanoma.
- Gliomas, including glioblastoma
- Meningiomas - from the meninges
- Pituitary adenomas
- Schwannomas of the auditory nerve
- Medulloblastomas in children
- Cancer metastases of other organs
Causes and risk factors
The causes of most primary brain tumors are unknown: they arise from random mutations in cells. Proven risk factors are few - exposure to the head, such as radiation therapy in childhood, and rare inherited syndromes. Mobile phone use, head trauma and stress are not recognized as causes of brain tumors. The risk of metastases is associated with the presence of cancer in other organs.
- Radiation therapy to the head area in the past
- Neurofibromatosis and other hereditary syndromes
- Age - for a number of tumors
- Malignant tumors of other organs
- Immunodeficiency - for brain lymphoma
Symptoms
Symptoms appear due to increased intracranial pressure, irritation of the cerebral cortex and compression of individual structures. A headache due to a tumor is usually new to a person, gradually intensifies, is stronger in the morning or when bending over and coughing, and is accompanied by nausea. An isolated headache without other symptoms that lasts for years is rarely associated with a tumor. A tumor of the pituitary gland can manifest itself as visual impairment and hormonal changes.
- Increasing headache, nausea, vomiting
- Epileptic seizures
- Weakness or numbness in half the body
- Speech, vision, hearing, balance disorders
- Changes in memory, behavior, personality
- Hormonal disorders in pituitary tumors
Diagnostics
If a tumor is suspected, an MRI of the brain with intravenous contrast is performed - the most informative method. CT is used in emergency situations and when MRI is contraindicated. The ophthalmologist examines the fundus of the eye, identifying swelling of the optic discs, and checks the visual fields. To plan the operation, special MRI modes are used, and, if necessary, PET. The final diagnosis is made based on the results of histological and molecular examination of tissue obtained during surgery or biopsy. If metastases are suspected, the primary tumor is looked for.
- Neurological examination
- Brain MRI with contrast
- MSCT of the brain
- Examination of the fundus and visual fields
- Biopsy, histology, molecular analysis
- EEG for epileptic seizures
Treatment
The tactics are determined by a consultation of a neurosurgeon, oncologist and radiotherapist. Small benign tumors without symptoms, such as meningiomas, can simply be monitored with follow-up MRIs. The main treatment method for most tumors is surgical removal to the maximum extent possible, including intraoperative monitoring of brain functions. After surgery, malignant tumors are treated with radiation and chemotherapy, and for molecular indications, targeted therapy. Stereotactic radiosurgery is used for small tumors and metastases. To reduce cerebral edema, corticosteroids are prescribed, and for seizures, antiepileptic drugs are prescribed. An important part of treatment is rehabilitation.
- Dynamic observation for small benign tumors
- Surgical removal
- Radiation therapy and radiosurgery
- Chemotherapy and targeted therapy
- Decongestant and antiepileptic therapy
- Rehabilitation and observation