Oncological diseases are extremely serious problems. This is especially true for those types of pathologies that affect the parts of the brain. In the article, we will touch upon one of these types of lesions - a cerebellar tumor. We will analyze in detail the symptoms of the disease, its characteristics, types of diagnosis and treatment.
What is it?
A cerebellum tumor is any benign or malignant lesion localized in this part of the brain. This is a pathology of both primary and secondary (metastatic) nature. Its symptoms are variable, they are conditionally divided into three categories - cerebellar, stem and brain.
The main direction of diagnosis is magnetic resonance imaging of the cerebral system. The final diagnosis is made only by the results of a histological examination of the sample of education.
The main direction of treatment of a cerebellar tumor is surgical. Therapy is aimed at the radical elimination of education, the restoration of the circulation of cranial cerebral fluids, the release of the brain stem from pathological compression.
If we turn to statistics, cerebellar tumors will make up 30% of the total mass of tumors developing in the brain. Today, more than a hundred of it (tumors) of morphological forms are known. Moreover, it is said that in 70% of the cerebellar glioma will act.
This pathology can affect a person at any age. However, some patterns are noted. Medulloblastomas are found mainly in children. Astrocytomas, hemangioblastomas - in middle-aged people. Elderly people are characterized by glioblastomas and metastatic formations.
The tumor most often affects men, as well as patients of the Caucasian race.
Reasons for the development of pathology
Today, experts can not accurately identify the etiological factors that provoke the development of a cerebellar tumor. Among the possible causes, the following is primarily revealed:
- Heredity (a factor characteristic of 10% of patients).
- A history of radiation exposure.
- The impact of oncoviruses - herpes, human papillomas, adenoviruses, etc.
- The effect on the body of chemical carcinogenic drugs.
- HIV infection, AIDS.
- Immunosuppressive therapy.
Common symptoms
First of all, a cerebellar tumor will be characterized by a general violation of coordination of movements, orientation in space. This is due to the main function of this part of the brain - coordination of both speech and movements. The general symptoms of a cerebellar tumor will be presented below.
Vomiting, nausea, headache. These signs are characteristic of both the early and late stages of neoplasm development. Growing, the tumor begins to block the fluid surrounding the brain. Such a detrimental effect leads to the development of hydrocephalus (enlargement, swelling of the skull), an increased content of fluid mass inside the skull.
Causes nausea and headache, increased intracranial pressure. The painful syndrome manifests itself strongly in the morning, after waking up. It can be of such intensity that it causes vomiting. During the day the pain subsides. Conventional anti-migraine medicines do not bring relief.
Impaired gait. It is the cerebellum that controls muscle coordination. Expanding, creating increased intracranial pressure, the tumor prevents the brain from properly performing its functions. The result is the clumsiness of the patient, a violation of the coordination of his movements. The gait also changes greatly. With this cancer, it is shaky and swaying.
The consequences of damage to the cranial nerves. Let's turn to anatomy. The cranial fossa in humans is characterized by a very small volume. A cerebellar tumor can completely occupy this space, damaging the adjacent structures. Most often they are cranial nerves. Their injury leads to the following:
- Peripheral vision loss.
- Constantly dilated pupils.
- Blur "pictures".
- Pupil deviation from normal position.
- Weakened facial muscles.
- Violation of taste perception.
- Hearing loss.
- Loss of sensitivity in some areas of the face.
Varieties of cerebellar cancer
A cerebellum tumor of the brain is primarily divided into such varieties:
- Cancer formation, metastatic to the cerebellum. For example, such a phenomenon is sometimes observed in cancer of the lungs, mammary glands.
- Oncogenesis, which initially began to develop in the cerebellum. These include astrocytoma and medulloblastoma.
In more detail, we consider the classification of a cerebellar tumor by its varieties:
- Gangliocytoma is dysplastic.
- Hemangioblastoma.
- Medulloblastoma.
- Astrocytoma.
Next, we will analyze the specific symptoms of a cerebellar tumor of the types presented.
Malignant and benign tumors
Cerebellar tumors are divided into two large groups:
- Benign formations. Infiltratively growing astrocytomas, as well as locally developing hemangioblastomas. They manifest themselves in the form of a cystic formation (a small node with a nearby cystic cavity).
- Malignant formations. The most obvious example is medulloblastoma. It has a fast pace of progression, can easily grow in subarachnoid spaces. In second place is cerebellar sarcoma.
Astrocytoma
The name is given according to the origins of the neoplasm - astrocytes located in the cerebellum. This tumor is characterized by slow growth. It rarely spreads to other parts of the brain. But cases of metastasis, even rare, still have a place to be.
Symptoms of a cerebellar tumor of this type of brain are as follows:
- Morning sickness, morning and night migraines. The manifestation is systematically repeated over several weeks or months.
- Ataxia and dysdiadochokinesia may develop with appropriate damage to the cerebellum. These signs help specialists determine the location of the tumor.
- Nausea, often ending with vomiting.
- Apathy.
- Loss of orientation in space.
- Confused thinking.
- Weakness in the limbs, numbness of the arms and legs.
- Visual impairment. The "picture" is doubled or blurred.
- Clouding of consciousness.
- Memory problems.
- Difficult, confused speech.
Medulloblastoma
First of all, we note the features of the development of this cerebellar tumor in children. Symptoms in young children in most cases are mild. Limited to the following:
- Change in habitual behavior.
- Some increase in head circumference.
- Lethargy and apathy.
- Vomiting In older children, this syndrome is more common than in infants.
When examining a small patient, a specialist can identify the front protruding fontanel, as well as the divergence of the bones of the skull. In older children, statistical ataxia, pathological head tilt, and an altered gait are often noted. What is this talking about? An abnormal inclination of the head indicates both paralysis of the block nerve and the growth of the neoplasm to the large occipital foramen. A potential threat to the patient's life is a protrusion of the cerebellar tonsils into this opening. This happens due to the same tumor pressure on the brain.
Medulloblastoma is characterized by the rapid development of the clinical picture. Therefore, specialists can diagnose the disease by the manifesting symptoms in less than two months.
One of the obvious manifestations of this oncological pathology in patients emerging from the infant period will be severe migraines and vomiting in the morning. Symptoms cause increased intracranial pressure. As we described above, it is caused by a blockade of a rapidly growing tumor of cranial fluids.
An examination of the fundus will also indicate increased intracranial pressure - optic edema is visible. This fact is accompanied by patient complaints of visual impairment. However, it will not be too pronounced. In a number of patients, paralysis of the fourth or sixth cranial nerve is additionally detected. Complaints of diplopia are also noted. It is also caused by pressure from the neoplasm. Some patients with medulloblastoma are diagnosed with speech disorders.
In most cases, the tumor affects the midline structures of the brain. This causes gait disturbance, ataxia of the body, nystagmus. Sometimes a violation of the letter, general clumsiness are visible.
As for adult patients, their medulloblastoma can be characterized by a unilateral manifestation. A common example is dysmetria.
Hemangioblastoma
A fairly rare type of cancer that affects the blood vessels of the brain. Such neoplasms can be localized in all areas of its spheres. However, it is most often found in the cerebellum, cranial posterior fossa.
By their characteristics, hemangioblastomas are benign neoplasms. However, they are anatomically located so close to the vital structures of the brain that the slightest damage to the latter leads to serious dysfunctions. Typical localization is the soft membrane surrounding the brain.
Hemangioblastoma manifests itself as follows:
- Headache.
- Nausea and vomiting.
- Altered gait.
- Double image in the eyes.
- Decreased visual acuity.
- Recurring dizziness.
- Mental, personality changes.
- Discomfort in the neck.
- Anorexia.
- Apathy, lethargy.
- Noises in the head.
- Chronic feeling of weakness in the limbs.
- Fainting.
- Speech impairment.
- Eye pains.
The listed symptoms can occur both abruptly and smoothly. The aggravation of the severity of the patient's condition most often indicates an open bleeding or an increase in intracranial pressure. Sometimes a tumor can manifest itself as a subarachnoid hemorrhage.
Hemangioblastomas are rarely diagnosed in small patients. Basically, they affect people 20-40 years old. Among men, cancer is diagnosed twice as often.
Dysplastic gangliocytoma
Belongs to the category of benign neoplasms. The appearance of gangliocytoma causes an abnormal development of the cerebellar cortex. Symptoms of this lesion are as follows:
- Dizziness.
- Migraine.
- Nausea and vomiting.
- Macrocephaly.
Less common in patients are convulsions, subarachnoid hemorrhages, orthostatic hypotension.
Often manifested in patients with diagnosed Cowden's syndrome. The pathology is complicated by diseases of the thyroid gland, oral papillomatosis, meningiomas, the formation of polyps in the digestive tract, and so on.
Diagnostics
Examination of the patient begins with a visual examination by a neurologist for external specific signs of pathology. Next, an ophthalmoscopy is performed - an examination of the fundus. The procedure allows you to assess the condition of the optic nerve, which is often affected by a tumor of the cerebellum.
Magnetic resonance imaging or computed tomography of the brain is required. It reveals the presence of education, its location and size. To exclude vascular tumor damage, an additional magnetic resonance cerebral angiography is performed.
Pathology treatment
As we mentioned, the main treatment is surgical. This is a radical dissection of education. But if it grows in the fourth ventricle, complex anatomical structures, then this makes it difficult to remove the cerebellar tumor. Then, to restore normal cerebrospinal fluid circulation, the maximum possible volume of pathogenic tissue is cut out.
Surgery on a cerebellar tumor is also a partial resection of the opening of the occipital bones, the first cervical vertebra. These manipulations help reduce the pressure of education on the brain stem.
To reduce hydrocephalus, with its sharp development, shunting measures, ventricular external drainage, and puncture of the cerebral ventricles are also shown.
After removal of the tumor, its matter is sent for histological analysis to determine malignancy, stage of development.
Additionally, the patient is prescribed chemotherapy and radiation therapy, taking sedatives, antiemetics, painkillers.
Forecasts
As for the prognosis for a cerebellar tumor, the results of treatment depend on the stage of its development, size. If this is a benign tumor completely removed during surgery, then the prognosis is favorable. When benign matter is not completely excised, relapse occurs after a while, and repeated surgery is required.
What are the effects of a cerebellar tumor? Without treatment, the patient dies from the fact that it compresses the respiratory and cardiovascular centers of the stem structures. The prognosis for malignant tumors is poor. The life expectancy of patients after surgery and adjuvant therapy is 1-5 years.
A cerebellar tumor is a serious pathology, the specific causes of which have not been elucidated. So far, medicine can only cope with benign such formations.