Miscellaneous

Cerebral meningioma: the operation and the prognosis for life

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cerebral meningioma - a disease that develops a long time, but if it is malignant neoplasm, doctors say its rapid growth and spread to other tissues and organs. In this case, the prediction will prompt removal of harmful tissue.

Scientists have found at least one more insidious kind of meningiomas - atypical. Certain medical conditions gave American neurosurgeon Cushing in 1922. When treating atypical form except for operation disease patient is a radiation therapy, as in the case of a malignant form.

What it is?

Meningioma - brain tumor, it is essentially benign. In meningiomas accounts for about 15% of all brain tumors. This tumor consists of arachnoid brain membranes. Most of the benign meningiomas has slow growth and reaches a large size, while remaining unnoticed. Growth is possible in several parts of the brain.

Meningioma located along the base of the skull and shell venous sinuses. Very often it occurs in the parasagittal sinus, the foramen magnum, in the cerebral hemispheres and the cerebellopontine angle.

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Causes of

Why developing meningioma, just could not figure out until now. It is known that the risk group includes women, people of the white race in the age of 40-70 years old, patients with cancer patients relatives, employees of nuclear power plants (support personnel nuclear reactors). You need to be afraid of HIV-infected people and those with lowered immunity, and underwent surgery to organ transplantation.

The following factors may affect the meningioma of the brain:

  1. Radiation exposure. It increases the risk of disease, especially at higher doses.
  2. Age. The disease can be detected in children and adolescents. But the greatest risk are people aged 40 - 70 years.
  3. Floor. Twice as likely to find a tumor in women, but men are more prone to malignant type tumors.
  4. Genetic disorders. Increase the risk of meningitis can Neurofibromatosis. With such disturbances may cause cancer or multifocal meningioma.
  5. Hormones. The risk of meningioma of the brain associated with the influence of estrogen, androgen and progesterone. Provoke disease can be hormonal disruptions during the menstrual cycle, pregnancy, and breast cancer.

Naturally, in order to protect itself from tumor development, we must try to avoid exposure to these factors. With regard to genetic defects, then there need qualified medical help.

Classification

Presented pathology has different shapes and forms. Everything depends on the high quality of education, the rate of its growth forecast and pathology. There are some forms of meningioma:

  1. Atypical, unusual. It can not be regarded as malignant, although it is growing much faster. Even after surgery meningioma of this form may appear again. Forecast in this case is relatively favorable, as the patient has to be kept under the control of the diagnostic.
  2. Typical. Such a tumor is almost no danger to life. It grows in the brain very slowly, and it can be removed completely. After surgery, cases of the disease relapses are rare. Life prognosis is generally positive. This form of brain tumor is found in 90-95% of cases.
  3. Malignant. This form of meningioma is the most dangerous, though less all fixed. It has developed rapidly and strongly to destroy the cells. Life expectancy is significantly reduced. Treat pathology can only be surgically, although this method practically does not give a positive effect. Prediction mostly unfavorable.

Localization

Most frequently intracranial meningiomas arranged parasagittal and falx (25%). Convexital in 19% of cases. On the wings of the sphenoid bone - 17%. Suprasellar - 9%. Posterior fossa - 8%. Olfactory fossa - 8%. Middle cranial fossa - 4%. Tentorium cerebelli - 3%. In the lateral ventricles, the foramen magnum and optic nerve to 2%.

Since the arachnoid mater covering the brain and spinal cord, and it is possible to develop so-called spinal meningiomas. This type of tumors is the most common intradural extramedullary tumors of the spinal cord in humans.

symptoms

Specific neurological symptoms in meningiomas not. Often, the disease can be asymptomatic for years, and its first manifestation in most cases becomes a headache. It just does not carry the specific nature and often appears to the patient as a dull, aching, arching, diffuse pain in the fronto-temporal area on both sides in the night and morning hours.

In general, brain meningioma is shown in the form of brain and local features. In the first case, the patient has symptoms suggestive of blood supply to brain deterioration and pressure formation in the brain centers:

  • dizziness;
  • headache, occurring preferably after sleep;
  • nausea;
  • weakness;
  • blurred vision, double vision;
  • reduced concentration and memory;
  • limbs cramp;
  • seizures;
  • causeless mood swings - from euphoria to depression, sadness and irritability.

Local symptoms (focal) occur depending on the location of the tumor:

  • blindness - in the formation of affecting bump sella;
  • impaired coordination and motor functions - the formation of meningiomas in the fossa, located on the back of the head;
  • reduction and hearing speech functions - when the tumor in the temporal lobes;
  • reduction of smell - When tumors affecting the frontal base;
  • protrusion of the eyes - with the defeat of the tumor eye orbit
  • oculomotor disorders - with meningioma, developing in the wing of the sphenoid bone.

Symptoms depend on the location of the tumor and may be expressed as a weakness in the extremities (paresis); decrease in visual acuity and visual field loss; the emergence of double vision and the omission of the century; sensitivity disorders in various areas of the body; seizures; the emergence of psycho-emotional disorders; just headaches. Advanced stages of disease, meningioma when reaching large dimensions causes edema and compression of the brain tissue, which leads to a drastic increased intracranial pressure, usually manifested by severe headaches with nausea, vomiting, depression of consciousness and the real threat to life patient.

diagnosis of meningioma

The most informative diagnostic methods with meningioma are the following:

  1. MRI - Magnetic Resonance Imaging is absolutely secure, so often used to check the patient's condition in the early stages of pre-operative and post-operative period recovery. MRI helps detect recurrent disease, and to determine the presence of tumors in the amount of only a few millimeters.
  2. Computed tomography - a survey conducted with contrast enhancement. CT signs indicate the presence of a tumor, as well as help identify the nature of the tumors without the need for additional diagnostic procedures. The cancer tends to accumulate contrast in their tissues, which becomes evident on CT scans.

To obtain an overall picture of the disease need to spend a few clinical tests and diagnostic procedures. Be sure to study blood. It may be necessary to hold a spinal tap to the detection of tumor markers, and angiography, for determining the degree of vascular injury.

How to treat meningioma?

The choice of the algorithm treatment of cerebral meningioma affects a large number of points:

  • tumor size;
  • its type;
  • location;
  • symptoms provoked by a tumor;
  • patient status;
  • its ability to withstand the procedure.

When the treatment is applied four approaches:

  1. Dynamic monitoring of the development of the tumor - the waiting tactics. It includes constant monitoring of meningioma by MRI, which takes place every six months. For patients with large tumors that are symptomatic, this method is not used. Suitable it is for elderly people or those with severe disabilities in health, not giving a more thorough treatment.
  2. Traditional radiation therapy - is indicated for multiple cancers that are difficult to locate, or else in the treatment of very large structures for radiosurgery. For the majority of brain tumors standard treatment beam is not so successful method of treatment as radiosurgery, and therefore remains sonovnom manner.
  3. Surgical removal of the brain meningioma - the operation of the operational meningioma removal has a great number of advantages. If the formation of benign and can be completely excised, then the probability of cure is very big. Furthermore, removal of the tumor provides material for a more accurate diagnosis.
  4. Stereotactic radiosurgery - the use of targeted radiation beams that destroy tumor cells without harming the surrounding tissue unaffected.

The main treatment for meningioma is considered its surgical removal. In superficial tumors operation gives a complete cure, and removal of such formation typically is not too difficult: the surgeon performs the craniotomy and tumor excised. If necessary, made of plastic formed defect own tissue or synthetic materials. During neurosurgical operations involved microscopic technique neuroimaging system and monitoring of the intervention.

If the tumor is adherent to the surrounding tissues tightly thereto are adjacent vessels and nerve fibers, the operation may be difficult and dangerous, and complete removal of the tumor tissue becomes impossible. In such cases, you can leave part of the tumor, and to terminate its further growth supplement surgery radiotherapy.

Treatment without surgery is indicated for patients who can not remove a tumor surgically, because of its deep position and the risk of complications. When a serious condition of the patient and the presence of comorbidity, when surgery and general anesthesia is extremely undesirable or contraindicated, radiosurgery is becoming the method of choice.

Recovery after removal of meningioma

Field of surgery the patient spends some time in a hospital under the supervision of doctors. Then it was discharged, and rehabilitation carried out at home. The patient and his family need to be constantly alert to when a relapse in time to reveal it. After the surgery, possible blood loss, infection, even if it was done with the observance of the rules.

If a person suddenly begins to lose vision, memory, begin to torment him headaches, you should see a doctor. It is important to constantly be observed at the neurosurgeon, attend a course of radiation therapy, especially if only part of the tumor was removed. For a full recovery may require additional treatments (acupuncture), the administration of drugs that reduce intracranial pressure, physical exercises.

Consequences and outlook

Recurrence in cerebral meningioma affects all three of its kind. For benign tumors possibility of relapse is 3%, atypical - 38%, malignant - 78%.

Its location affect the 5-year recurrence index. The smallest index among neoplasms in calvaria (3%) for the area sella - 19%, the body of the sphenoid bone - 34%. The highest index ratio when a meningioma sphenoid wing and cavernous sinus (60-100%).

Tumor III level for all events received treatment increases the life expectancy of 2-3 years. The younger the patient is, the more favorable it forecast.

The best result is achieved with the full removal of the tumor.

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