What Are the Different Types of Ganglion Cyst Surgery?

Glioma, referred to as glioma, is a tumor that occurs in the neuroectoderm. There are two types of tumors occurring in neuroectoderm. One is formed by mesenchymal cells, called glioma; the other is formed by parenchymal cells, called neuronal tumor. Because the two types of tumors cannot be completely distinguished from the etiology and morphology, and gliomas derived from mesenchymal cells are more common than neuronal tumors derived from parenchymal cells, neuronal tumors are included in the gel. Gliomas are collectively called gliomas.

Ganglioglioma

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Glioma, referred to as glioma, is a tumor that occurs in the neuroectoderm. There are two types of tumors occurring in neuroectoderm. One is formed by mesenchymal cells, called glioma; the other is formed by parenchymal cells, called neuronal tumor. Because the two types of tumors cannot be completely distinguished from the etiology and morphology, and gliomas derived from mesenchymal cells are more common than neuronal tumors derived from parenchymal cells, neuronal tumors are included in the gel. Gliomas are collectively called gliomas.

Chinese name

Ganglioglioma

Foreign name

Ganglion gliomas

Overview

Tumors of the neuroectoderm

Therefore also

Neuroectodermal tumors or neuroepithelial tumors

Glioma is a tumor that occurs in the neuroectoderm, called a neuroectodermal tumor or a neuroepithelial tumor. Tumors originate from neurointerstitial cells, that is, glial, ependymal, choroid plexus epithelium, and neural parenchymal cells, that is, neurons. Most tumors originate from different types of gliomas, but according to the histogenetic origin and biological characteristics, various re-examination tumor diseases that occur in the neuroectoderm are generally called gliomas.

Gliomas are more common in men, especially in glioblastoma multiforme and medulloblastoma. Men are more common than women. All types of glioblastomas are more common in middle age, ependymal tumors are more common in children and young people, and almost all myeloblastomas occur in children. The location of gliomas is also related to age. For example, cerebral astrocytomas and glioblastomas are more common in adults, and cerebellar gliomas (astrocytomas, medulloblastomas, and ependymal tumors) are more common in children. .

Most gliomas develop slowly, and the time from onset of symptoms to consultation is usually several weeks to several months, with a few years. Highly malignant and posterior fossa tumors have a shorter history, and more benign or quiet tumors have a longer history. If the tumor has bleeding or cystic changes, the symptoms will suddenly worsen, and there is even a pathogenesis similar to cerebrovascular disease. The clinical symptoms of glioma can be divided into two aspects. One is the symptoms of increased intracranial pressure, such as headache, vomiting, vision loss, diplopia, mental symptoms, etc .; the other is the tumor produced by the compression, infiltration and destruction of brain tissue. Symptoms can manifest as irritating symptoms such as localized epilepsy in the early stages and neurological deficits such as paralysis in the later stages.

The diagnosis of glioma is analyzed according to its biological characteristics, age, gender, predisposition site and clinical process. Based on the history and signs, auxiliary examinations such as electrophysiology, ultrasound, radionuclide, radiology and nuclear magnetic resonance are used. The positioning accuracy rate is almost 100%, and the qualitative diagnosis accuracy rate can be more than 90%.

According to reports,

The course of glioma varies according to its pathological type and the length of the location. The time from the onset of symptoms to the time of consultation is usually several weeks to several months, and a few can reach several years. Highly malignant and posterior fossa tumors have a shorter history, and more benign tumors or tumors located in so-called quiet areas have a longer history. If the tumor has bleeding or cyst formation, the development of symptoms can be accelerated, and some may even resemble the development of cerebrovascular disease.

There are two main symptoms of the symptoms. The first is increased intracranial pressure and other general symptoms such as headache, vomiting, vision loss, diplopia, seizures, and mental symptoms. The other is the local symptoms caused by the tumor's compression, infiltration and destruction of the brain tissue, resulting in the loss of nerve function.

Most headaches are caused by increased intracranial pressure. Tumors grow gradually. Intracranial pressure gradually increases. Compression and involvement of intracranial pain-sensitive structures such as blood vessels,

As the tumor gradually grows, intracranial space-occupying lesions are formed, often accompanied by peripheral brain edema. When the compensation limit is exceeded, intracranial pressure increases. When the tumor blocks the cerebrospinal fluid circulation or compresses the vein, which causes venous return disorders, the intracranial pressure increases. If bleeding, necrosis and cyst formation occur in the tumor, the process can be accelerated. When the intracranial pressure increases to a critical point, the intracranial volume continues to increase slightly, and the intracranial pressure will increase rapidly. For example, when intracranial pressure monitoring is performed, when the pressure reaches 6.67 to 13.3 kPa Hg, plateau waves appear, and plateau waves repeatedly appear for a long time, which is a clinical sign. When intracranial pressure equals arterial pressure, cerebral vascular paralysis, cerebral blood flow stops, blood pressure drops, and the patient will soon die.

The tumor is enlarged, the local intracranial pressure is the highest, a pressure gradient is generated between the intracranial sub-cavities, causing the brain to shift, and gradually worsening, a cerebral hernia is formed. Tumors in the hemisphere of the brain can produce a hernia of the brain, and the cingulate can move back over the midline, which can cause wedge-shaped necrosis. Peri-iliac arteries can also be displaced under pressure, and severe cerebral infarction can occur in the supply area. More important is the cerebellar notch hernia, that is, the medial temporal sulcus gyrus through the cerebellar notch to the posterior cranial fossa. The ipsilateral oculomotor nerve is paralyzed, the pupils are dilated, and the light response disappears. Compression of the cerebral feet of the midbrain produces contralateral hemiplegia. Sometimes the contralateral cerebral foot is compressed on the edge of the cerebellum or the tip of the bone, causing ipsilateral hemiplegia. The posterior choroidal artery and posterior cerebral artery can also be compressed to cause ischemic necrosis. Finally, compression of the brainstem can cause a downward axial displacement, leading to hemorrhage of the midbrain and upper pontine infarction. The patient was in a coma, his blood pressure rose, his pulse was slow, his breathing was deep and irregular, and he had stiffened brain. Finally, breathing stopped, blood pressure dropped, and cardiac arrest ceased and died. Suboccipital posterior cranial fossa tumors can produce a foramen magnum hernia, and the cerebellar tonsil is displaced downward to produce a foramen magnum. Severe medulla ventral pressure on the anterior edge of the foramen magnum. Superficial tumors can also be accompanied by foramen magnum hernia. Caused by bulbar ischemia, the patient was comatose, the blood pressure increased, the pulse was slow and strong, and the breathing was deep and unplanned. Then breathing stopped, blood pressure dropped, pulse rate weakened, and eventually death.

Gliomas are most common among various tumors in the skull. Among gliomas, astrocytoma is the most common, followed by glioblastoma multiforme, and ependymal tumors occupy the third place. According to statistics from Beijing Xuanwu Hospital and the Affiliated Hospital of Tianjin Medical College, among 2573 cases of gliomas, they accounted for 39.1%, 25.8%, and 18.2%, respectively.

Gender is more common in men, especially in glioblastoma multiforme and medulloblastoma, which are significantly more men than women. Most ages are seen between the ages of 20 and 50, with the highest peak at 30 to 40 years old. In addition, children are more common around the age of 10, which is another small peak.

Each type of glioma has its own onset age. For example, astrocytoma is more common in adulthood, glioblastoma multiforme is more common in middle age, and ependymal tumors are more common in children and young people. Happened to children. Different types of gliomas have different locations. For example, astrocytomas occur mostly in the adult hemisphere, and in children, they occur in the cerebellum. Glioblastoma multiforme occurs almost exclusively in the cerebral hemisphere; Membrane tumors are more common in the fourth ventricle; oligodendroglioma mostly occurs in the cerebral hemisphere, and almost all myeloblastomas occur in the cerebellar vermis.

Make a diagnosis based on age, gender, site of occurrence, and clinical process, and estimate its pathological type. In addition to the medical history and neurological examination, some auxiliary examinations are needed to help diagnose localization and characterization.

Cerebrospinal fluid examination

Glioblastoma has the highest incidence in brain tumors, accounting for about 40.49%, and the peak age of comprehensive onset is 30-40 years, or 10-20 years. Glioma in the cerebral hemisphere accounts for about 51.4% of all gliomas, with astrocytomas the most, followed by gliomas and oligodendroglioma, and the ventricle system is also the site of more gliomas. , Accounting for 23.9% of the total number of gliomas, mainly for meningiomas, medulloblastoma, astrocytoma, cerebellar gliomas account for 13% of the total number of gliomas, mainly astrocytomas.

1990.WHO classifies gliomas

Astrocytic tumor

Astrocytoma

2. Anaplastic (malignant) astrocytoma

3. Glioblastoma

4. Hair cell type astrocytoma

5. Subventricular giant cell astrocytoma

Mixed glioma

1. Mixed oligodendroblastoma

2. Anaplastic (malignant) oligo-astrocytoma

Choroid plexus tumor

Choroid plexus papilloma

Choroid plexus cancer

Oligodendrocyte tumor

1 oligodendroglioma

2. anaplastic (malignant) oligodendroma

Neuroepithelial tumors of unknown origin

Astroblastoma

2. Astroblastoma

3. Gliomatosis of the brain

Ependymal tumor

Ependymal tumor

2. Anaplastic (malignant) ependymoma

3. Myxic papillary ependymoma

4. Subventricular Tumor

Pineal tumor

Pineal somatic cell tumor

2. Pineal gland blastoma

3. Mixed pineal cell tumor-pineal tumor

Embryonic tumor

Medullary epithelioma

2. Neuroblastoma

3. Epimental blastoma

4. Retinoblastoma

5. Myeloblastoma

Neuroglioblastoma

Ganglion cell tumor

2. Ganglioglioma

3. Anaplastic (malignant) ganglioglioma

4. Central neurocytoma

5. Olfactory neuroblastoma

Astrocytoma: General symptoms include increased intracranial pressure, headache, vomiting, optic papillary edema, visual field changes, epilepsy, diplopia, cranial enlargement (childhood), and changes in vital signs.

2.Symptoms vary depending on where the tumor grows

Cerebral astrocytoma: epilepsy occurs in about 1/3 of patients with epilepsy as the first symptom.

Cerebellar astrocytoma: ataxia of the affected limb, awkward movement, unstable holding, low muscle tension and tendon reflex.

Thalamic astrocytoma: paresis on the contralateral limb of the lesion, sensory disturbance and spontaneous pain in the half body, ataxia and dance-like movements of the affected limb, psychiatric disorders, endocrine disorders, and contralateral blindness. Visual impairment and hearing impairment.

optic astrocytoma: mainly manifested as visual impairment and abnormal eye position.

Third Ventricular Astrocytoma: Patients with obstructive hydrocephalus often present with severe paroxysmal headaches, and may experience sudden loss of consciousness, mental disorders, memory loss, etc.

Brain stem astrocytoma: Central tumors often manifest as ocular dyskinesia, pontine tumors often manifest as limited eye abduction, facial and trigeminal nerve involvement, and bulbar tumors often present as swallowing disorders and changes in life signs.

Glioblastoma: The tumor is highly malignant and grows quickly, with a short course of disease. Most of the patients have symptoms within 3 months from the onset of symptoms. The symptoms of high intracranial pressure are obvious. 33% of patients have seizures, and 20% of patients have indifferent, dementia, Mental symptoms such as mental retardation, (patients) may appear to varying degrees of hemiplegia, sensory disability, aphasia and hemiopia.

Oligoglioblastoma and anaplastic (malignant) oligodendroglioma: epilepsy is often the first symptom, and mental symptoms are mainly emotional abnormalities and dementia. Violation of movement and sensory areas can produce hemiplegia, hemiplegia, and aphasia. Etc. The symptoms of high intracranial pressure appeared later.

Myeloblastoma:

The tumor grows fast and the symptoms of high intracranial pressure are obvious

Cerebellar dysfunction manifested as staggering gait and unstable walking.

diplopia, facial paralysis, enlarged head (children), and cough.

Tumor metastasis is an important feature of medulloblastoma.

Ependymal tumor

Increased intracranial pressure

symptoms of brainstem compression (vomiting, coughing, pharyngeal difficulties, hoarseness, breathing difficulties), cerebellar symptoms (unstable walking, nystagmus, etc.), hemiplegia, dyskinesia, etc.

The recurrence rate after surgery is almost 100% and prone to spinal canal metastasis.

Choroid plexus papilloma:

1. Hydrocephalus and tumor occupying cause symptoms of high intracranial pressure, and children often have enlarged skulls; they are indifferent, lethargic or irritable.

2. Patients with tumors located in the lateral ventricle have contralateral pyramidal tract signs; those with posterior cranial depression have unstable walking, nystagmus, ataxia, and those with third ventricle have difficulty with upper vision in both eyes.

Pineal somatic cell tumor: increased intracranial pressure; hearing and eye movement disorders that affect lower vision manifested as diabetes insipidus, drowsiness, and obesity, and endocrine symptoms manifested as sexual stagnation or underdevelopment; some patients may experience seizures And disturbance of consciousness.

The growth characteristics of glioblastoma are invasive growth, and there is no obvious boundary with normal brain tissues. Most of them are not limited to one brain lobe, and the fingers outside the brain tissue destroy the brain tissue with fingers. The benign ones grow slowly and have a longer course. The average time from onset of symptoms to consultation is two years. Malignant tumors grow rapidly and have a short course of disease. Most of them are within 3 months from the onset of symptoms to consultation, and more than 70-80% are within six months.

The treatment of glioma at home and abroad is generally surgery, radiotherapy, chemotherapy, X-knife, -knife and so on.

Surgical treatment is based on the growth characteristics of gliomas. In theory, it is impossible to completely remove the operation. Some tumors growing in important parts such as the brain stem cannot be operated at all. Therefore, the purpose of surgery can only be limited to the following 5 aspects. Pathological diagnosis, reduce tumor volume and tumor cell number, improve symptoms and relieve symptoms of high intracranial pressure; prolong life and create opportunities for other subsequent comprehensive treatment; obtain tumor cell dynamics data to provide a basis for finding effective treatment.

1. Oligocytoma and anaplastic glioma: Brain tumors are longer than white matter, are soft, and have a wide range of infiltration. They can penetrate into the ventricles and the surface of the cortex, and some tumors can undergo cystic changes. Some tumors develop mucus-like changes. Agglomerates into jelly-like substances with rounded nuclei. Malignant oligodendroblastoma is more rounded in shape. There is more cytoplasm, and individual tumor cells can be seen spreading with cerebrospinal fluid. Most clinical oligodendroglial gliomas grow slowly and have a long course of disease. The average time between symptoms and consultation is 2 to 3 years. Epilepsy is the first symptom of this disease. Extensive tumor infiltration is visible. Emotional abnormalities and mental symptoms of dementia. Later tumors invade movement, and hemiplegia, dyskinesia, and motor sensory aphasia occur in the sensory area.

2. Optic nerve cell glioma: tumors occur in the optic nerve foramen and optic cross section. The tumor is mainly located in the posterior half of the eyeball. The optic nerve foramen can expand due to tumor growth. The base of the brain and the hypothalamus area, even the three ventricles burst into or oppressed the lateral ventricles, the tumor can also affect the entire optic nerve, and make the optic nerve diffuse thickening and thickening

3. Cross cell glioma: Tumors are common in adolescents or young adults. The incidence is low and the malignancy is high. Glioma can originate from the optic nerve and optic cross glioma. In children, gliomas from the cross of the optic can invade the hypothalamus; gliomas from the hypothalamus can also spread to the cross of the optic. Optic gliomas are mostly hair cell astrocytomas, which are relatively benign tumors. Gliomas in the optic cross section have a high degree of malignancy, and the tumors are often slightly cystic, with or without accumulation of proteinaceous matter, producing a myxomatous phenomenon.

The results of the dietary fiber and glioma study showed that the control group consumed more vegetables and fruits than the case group and showed a negative correlation. It is suggested that vegetables and fruits have protective effects on gliomas. Studies such as Martin found that fruits and vegetables rich in vitamins are protective against brain tumors, especially citrus fruits are more protective against brain tumors. Vegetables, fruits, and cereals are rich in dietary fiber, mainly cellulose, lignin, hemicellulose, polypentose, gum, and pectin. These substances can reduce the incidence of tumors such as colorectal cancer. Dietary fiber can prevent cancerous changes induced by certain chemical carcinogens, and can regulate hormones or endogenous tumor suppressors in the body. Regarding the anti-cancer mechanism of dietary fiber, it is currently believed that: dietary fiber can reduce the concentration of carcinogens in the large intestine; can shorten the passage time of intestinal toxins and reduce the contact time between carcinogens and tissues; can affect some carcinogens Or the production of pre-carcinogens; it has a regulatory effect on the endocrine system, which affects the tumor formation and development.

There are many ways to classify gliomas, and clinicians often use the simpler Kernohan classification. Among the various types of gliomas, astrocytomas are the largest, followed by glioblastomas, followed by medulloblastomas, ependymal tumors, oligogliomas, pineal tumors, and mixed gums. Plasma tumors, choroid plexus papilloma, unclassified gliomas, and neuronal tumors. Different types of gliomas have different locations. For example, astrocytoma is more common in the cerebral hemisphere in adults, and more common in the cerebellum in children. Glioblastomas occur almost in the cerebral hemisphere; medulloblastomas occur in the cerebellar worm. Ependymal tumors are more common in the fourth ventricle; oligodendroglioma mostly occurs in the cerebral hemisphere.

Glioma is a highly recurrent brain tumor disease. There is currently no effective means to prevent relapse. The relapse time of this disease depends on the degree of differentiation and treatment. Most traditional treatments usually relapse within 1-5 years. Regular follow-up visits and active treatment after relapse.

A significant proportion of gliomas recur after surgery due to failure to resect or grow the tumor. In the past 30 years, the treatment methods and examination methods of intracranial tumors have been continuously developed in modern medicine at home and abroad, but the surgery is not clean and the recurrence rate after surgery is high. Although there are many treatment methods and drugs for preventing recurrence, But judging from the treatment effect of many patients, there has been no major progress. Compared with non-radiotherapy and chemotherapy, intracranial malignant tumors are treated with radiotherapy and chemotherapy, and the length of recurrence is not much different. Most people only increase the side effects.

Glioma patients should eat

(1) Foods resistant to brain tumors, such as wheat, barley, coriander, jellyfish, asparagus, fried gecko, fried whole scorpion, fried pupae, fried silkworm pupae, pupae, and kelp.

(2) Foods that have the effect of protecting intracranial blood vessels should be eaten: celery, amaranth, chrysanthemum brain, coriander white, sunflower seeds, kelp, jellyfish, oysters, and clams.

(3) It is advisable to eat foods with the function of preventing and treating intracranial hypertension: corn whisker, red beans, walnut kernels, laver, carp, duck meat, stone clams, kelp, crab, clams.

(4) Eat foods with eye protection: chrysanthemum, malantou, amaranth, sheep liver, pork liver, eel.

(5) Foods with side effects of protective chemotherapy and effective treatment: shiitake mushrooms, white fungus, black fungus, day lily, walnuts, sesame, sunflower seeds, kiwi, sheep blood, pig blood, goose blood, chicken blood, lotus seeds, green beans, Barley, catfish, green beans, coriander, shark, plum, almond, bergamot.

(1) Avoid excitable drinks such as coffee and cocoa.

(2) Avoid spicy and irritating foods, such as onions, garlic, chives, pepper, pepper, cinnamon and so on.

(3) Avoid moldy and charred foods, such as moldy peanuts, moldy soybeans, and charred fish.

(4) Avoid greasy, cured meat, fried, smoked food.

(5) Avoid salty foods.

(6) Avoid tobacco and alcohol.