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Special mention of tumors
A. Glioma
Glioma , Tumour originating from the glial cells are called glioma. Glial cells are the non neuronal cells of the brain and the spinal cord. They can be differentiated in many ways
1. By Origin
Ependymoma — ependymal cells Astrocytomas, Glioblastoma multiforme is the most common astrocytoma. Oligodendrogliomas —Oligodendrocytes, Mixed gliomas, such as Oligoastrocytomas - contain cells from different types of glia.
2. By Grade of the tumour-
Low-grade gliomas are well-differentiated these are benign, WHO Grade I, and carries a better prognosis for the patient. Examples – Pilocytic Astrocytomas, Myxopapillary Ependymoma
High-grade gliomas are undifferentiated or anaplastic; these are malignant tumour and carry a worse prognosis. Examples: Anaplastic, Astrocytoma, Glioblastoma Multiforme
3. By location
- Supratentorial: Above the tentorium
- Infratentorial : Below the tentorium, in the cerebellum, mostly in children (70%)
- Pontine: Located in the pons of the brainstem. The Pons controls critical functions such as breathing making surgery extremely dangerous.
High-grade gliomas are highly-vascular and have a tendency to infiltrate in the surrounding tissues. They have extensive areas of necrosis and hypoxia. Often tumor growth causes a breakdown of the blood brain barrier in the vicinity of the tumor. As a rule, high-grade gliomas almost always grow back even after complete surgical excision.
On the other hand, low-grade gliomas grow slowly, often over many years, and can be followed without surgical treatment unless they grow and cause symptoms.
Symptoms
Symptoms of gliomas depend on which part of the central nervous system is affected. A brain glioma can cause headache, nausea, vomiting, seizures, and cranial nerve disorders as a result of increased intracranial pressure. Spinal cord gliomas can cause pain, weakness or numbness in the extremities. Gliomas do not metastasize by the bloodstream, but they can spread via the cerebrospinal fluid and cause "drop metastases" to the spinal cord.
Treatment
Standard therapy
Treatment for brain glioma depends on the location, the cell type and the grade of malignancy. Often, treatment is a combined approach, using surgery, radiation therapy, and chemotherapy. Spinal cord tumors can be treated by surgery and radiation.
Prognosis
Gliomas cannot be cured. The prognosis for patients with high-grade gliomas is generally poor, and is especially so for older patients. Survival of the anaplastic astrocytoma is about three years. Glioblastoma multiforme has a worse prognosis with less than 12 month survival after diagnosis.
Team of Specialists:
- Dr. Arun Saroha Head - Neurosurgery (Unit I) View Profile
- Dr. Alok Gupta Head - Neurosurgery (Unit II) View Profile
- Dr. Praveen Gupta Head - Neurology View Profile