Encephaloma clinical manifestation 1
May 6th, 2008 Guage
1. general symptom
1) headache: The cerebrospinal fluid pressure advances or the tumor direct pressure stimulation meninx, the blood vessel and the nerve receives the stimulation to pull pulls the result. Sees in the large number patient, is the incipient symptoms, aggravates along with the tumor development.
2) vomits: Many because the cerebrospinal fluid pressure increases the stimulation medulla oblongata vomit main center, the fan to be distracted undergoes pulls to the stimulation pulls causes. The headache is heavy when the concurrent vomit, often assumes the spraying shape. After the young child, the cranial fossa tumor presents the vomit and early frequent, Yi Wuwei stomach illness.
3) visual distrubance: Including vision, field of vision and eyeground’s change, because the cerebrospinal fluid pressure markup has the optic papilla dropsy or the tumor direct pressure optic nerve, might in the course of time all send the optic atrophy to affect the vision, causes the eyesight fail even to lose one’s sight. Has the optic papilla dropsy’s reason is the cerebrospinal fluid pressure advances, causes around the optic nerve the lymph sheath endolymph backflow to limit as well as the eye venous pressure advances, vein ecchymosis result. In addition, but may also have dizziness, the diplopia, the energetic symptom, the epileptic paroxysm, the neck strong straight, life symptom and so on corneal reflex decrease and breath and blood pressure changes.
2. partial symptom
The partial symptom also calls the localization symptom, as a result of the sol lump in the spot difference, the partial symptom which its produces also different. Clinical may act according to its performance, unifies other judgment tumor the position. And the most important infection symptom, namely the tumor direct pressure stimulation either the destruction brain organization or cranial nerve’s result, has the localization value. But is taken bad the initial period to appear most has the diagnosis significance. In later period, because other spot’s brain organization and the cranial nerve is oppressed, dropsy and involves and so on indirect influence, but presents some tumors the neighbor symptom and is widely separated by the symptom.
The former is because of tumor nearby brain or the cranial nerve bearing result. If the cerebellum tumor presents the pons, the medulla oblongata symptom; The temporal lobe tumor appearsⅢ,ⅣCranial nerve barrier; The flank crack tumor presents hemiparalysis and so on. The above symptom’s occurrence, with the tumor oppression, the brain organization shifts or the brain blood circulation barrier and so on concerns. Is widely separated by the symptom is widely separated by the spot in the tumor cranial nerve’s function barrier, after like skull, the nest tumor, because of the hydrocephalus influence volume, nie, the parietal lobe, may appear regards, listens to the illusion or epilepsy. When like cerebrospinal fluid pressure markup, because the third ventricles of the brain expand may also present the pair of nie side blind in one eye and the enlarged sella and so on.
The following is each kind of encephaloma’s concrete symptom:
(one) sol lump
The neuroglia lump from the nervous system support organization, is the ectoblast tumor. Many sol lump its lump cell and mature or the immature spongiocyte is similar, based on this kind of understanding, has the principle according to the organization to carry on the classification, divides into the star type cytoma, to become the star type cytoma, the myelinization cytoma, the few sol cytoma, the ependyma lump, the pinealoma, the nerve epithelioma.
In recent years divided into the I-IV level according to the sol lump’s malignant degree, the rank ordinal number is higher, its malignant degree was bigger, namely the lump cell differentiation was good, the non-nuclear fission and the blood vessel proliferation is I level; Has 25%~50% for the malignant cell is II level; 50%~75% are III level; 75%~100% are IV level. In malignancy Gao Zheliu the common necrosis and the hemorrhage, the blood vessel is rich, the blood vessel outer layer and the endothelial cell have the obvious proliferation.
1. star type sol cytoma
This is in the sol lump most seeing, occupies the sol lump 51.2%, this sickness most is common in the adult has the spot is the volume goes against, the temporal lobe and so on, the child occurs much in the cerebellar hemisphere. The star type cytoma is slow-growing, the course is long, if the tumor located in the cerebral hemisphere, its clinical characteristic presents epilepsy, the body paralysis and the feeling barrier and so on, the cerebrospinal fluid pressure markup drafts appears late, therefore has the long-term epileptic paroxysm not to have other symptoms. If grows in the cerebellum, will have the symptom which and the symptom the cerebellum harms, like altogether Jinan is out of balance, nystagmus, the change movement barrier and so on; When it oppresses the fourth ventricles of the brain, then makes the cerebrospinal fluid pressure to advance, causes the headache, vomitive, symptoms and so on optic papilla dropsy. Occurs 40% is located at the brain hemisphere in child’s star type cytoma, approximately composes 10% located at the brain stem, the latter first displays the brain stem tumor each kind of clinical manifestation, like overlapping paralysis and so on. Sometimes may also affect the cerebellum to have the corresponding symptom. The approximately 8% star type cytoma see the tumor calcification stove on X even piece.
2. polymorphic collagen cytomas
This sickness for the adult cerebral hemisphere common tumor, occupies the sol lump 23.5%, occurs in 40 year-old about adult, often is located at the cerebral hemisphere, grows from the white matter extends the cerebral cortex, even may reach the meninx. The child is rare, and grows in the brain stem. This kind of sol lump is one malignancy very high tumor, its clinical characteristic progresses quickly for the condition, course often within 1 year, because the tumor grows in the cerebral hemisphere, but presents hemiparalysis, the aphasia and each kind of feeling barrier rapidly and so on. The cerebrospinal fluid pressure markup appears early, occasionally has because of the lump internal hemorrhage, has symptoms suddenly and so on stupor, hemiparalysis, even is misdiagnosed for the blood vessel of brain accident. Approximately some 21% patient are the limited symptom, 27.3% patients have the epileptic paroxysm, because the tumor blood vessel supply is rich, the approximately 24.1% patients in the angiography may see that the tumor the pathology circulation, displays for the tumor area blood vessel increases, forms the network of bloodvessels. In the vein time, the expanded vein may form the winding rope shape the phantom, may present arteriovenous anastamosis.
3. ependyma lump
This kind of encephaloma occupies the sol lump 11.3%, for sol lump’s 3rd, common in the child and the adult, this sickness’s characteristic for the overwhelming majority tumor located at the fourth ventricles of the brain, encephaloma located at the curtain on, is mainly located at the ventriculi laterals enciphali and the third ventricles of the brain, its symptom is different because of the tumor in the spot and is different, by the headache, vomitive, the eyesight fail and cerebrospinal fluid pressure markup symptoms and so on optic papilla dropsy most sees. The tumor occurs located at the curtain on behind the pillow the ache. After the neck, the ache possible tumor to have invaded in the neurocanal, and may have a force position. Located at the ventriculi laterals enciphali, has the body to move the barrier and the feeling barrier, or nie the angle may have in the ventriculi laterals enciphali Delta Region with the side blind in one eye. The tumor located at the ventricles of the brain is specially when in the fourth ventricles of the brain may move, the patient decubitus is improper, sends the ventricles of the brain obstruction, may send the headache, the vomit aggravates, even stupor. Located at the curtain, mostly has nystagmus, altogether Jinan is out of balance. The child (below 6 years old may have the encephalic water specially). Encephaloma oppresses the medulla oblongata or to the cerebellum pons angle extension when downward presents Vth, VII, IX, XII and so on cranial nerves to exhaust oneself the symptom, the approximately 7.4% patients may see the tumor calcification on the skull even piece.
4. myelinization sol cytoma
This kind of sol lump for the child fossa cranii posterior median line most common tumor, occupies the sol lump 4.2%, occupies the child encephalic tumor 15.1% to 18%. The clinical characteristic to often rapidly present the cerebellum median line the symptom and the symptom. The early time namely has the headache, vomitive, the eyesight fail, cerebrospinal fluid pressure markup symptoms and so on optic papilla dropsy. Because the tumor is located at the vermis, therefore displays for torso altogether Jinan is out of balance, the lower limb is more serious than the upper limb, appears walks, the gait to limp, to raise the eldest brother not steadily to draft and so on positive. When tumor located at one side cerebellar hemisphere, then presents one-sided altogether Jinan to be out of balance, the myo- tensity to drop, cerebellar hemisphere harm and so on nystagmus symptoms. The approximately 1/10 case clinical has the spinal cord shift symptom.
5. few sol cytoma
This sickness for the adult rare slow-growing tumor, only occupies the sol lump 2.99%. Its clinical characteristic for mostly grows in the cerebral hemisphere, because its growth is very slow, the cerebrospinal fluid pressure markup drafts appears late, often displays has epilepsy, the aphasia, hemiparalysis, the pyramidal tract to draft and the feeling barrier and so on, but not obvious cerebrospinal fluid pressure markup symptom. X optical glass has 68% to see the tumor calcification. The individual malignancy high case may have skulls and so on under outside scalp, cervical lymphatic glands to shift, and may follow under the arachnoidea the cavity to spread.
6. pinealoma
This sickness is rare, approximately composes the sol lump 1.3%, mainly sees in the child or the young people. Its clinical characteristic namely causes the cerebrospinal fluid pressure for the early time to advance, has the headache, vomitive, the eyesight fail, optic papilla dropsy and so on. When tumor oppression neighbor brain organization, then has a series of symptoms and the limited symptom. If oppresses or affects four pack of bodies and the inside and outside geniculate body, may produce the eye movement barrier, the pupil expands, light response vanishing, presents the blurred vision, the field of vision damage or the peripheral field of vision reduction and so on. Specially on two regards cannot, is on the earthen mound bearing localization symptom, when oppresses the cerebellum or the brachium conjunctivum, then presents altogether Jinan to be out of balance. The pine cone somatic cell possibly has the endocrine function, but also possibly is because of the tumor blocking water conduit, produces in the brain the water, the third ventricles of the brain expand the hypothalamus function barrier performance which causes. The pinealoma also possibly passes through the cerebrospinal fluid circulation to spread to the spinal cord. The skull even piece partial cases may demonstrate that has the calcification.
(two) meningioma
The meningioma calls the arachnoidea endothelioma, is primary on the encephalic meninx’s tumor, approximately composes the encephalic tumor 15.7%, but only accounts for 3.1%~6.9% in the child encephaloma. This sickness occurs in 20~50 year-old adult. Its average has the age is 30~33 years old. Course average many above 2~3 years, generally thought that the tumor stems from the arachnoidea down, therefore good occurs nearby the venous sinus. Its clinical characteristic varies because of the tumor spot. The meningioma good sends in the cerebrum convex and sagittal plane Dou Pangzhan 66.5%, latter skull concave 14%, sphenoid bone 87%, skull concave 4.4%, sulcus olfactorius 2.3%, saddle area 2.1%.
1. cerebrum convex meningioma
Often in the brain surface, has the adhesion with the meninx, may also in the brain essence. Because the tumor is different in the spot, therefore its clinical manifestation is dissimilar, from the energetic symptom to the movement barrier, the feeling barrier, the field of vision damage may appear, epilepsy formation rate is high, often and is the first round symptom, may also have the symptom which and the symptom the cerebrospinal fluid pressure advances.
2. nearby arrowy Dou meningioma
The head semblance is sometimes detectable sticks out gradually partially, even has the tenderness, the head even piece may see that the ossein proliferation or the ossein destroy, the meninx hemal canal to broaden and so on changes. When tumor located at arrowy Dou first 1/3, may have the length time headache, the eyesight fail, the cerebrospinal fluid pressure to increase the higher symptom, and has the energetic symptom (for example memory to drop, sluggish, easy weary and so on) and the epileptic paroxysm, the partial patients may have the opposite side main center facial nerve paralysis or the body movement barrier.
3. sphenoid bone ji meningioma
This spot’s tumor often easily produces the sphenoid bone winglet or the sphenoid bone ji ossein proliferation, creates kuang the wall accumulation; kuang in the volume changes is small, forms the one-sided protruding eyeballs, and may present the eyelid and the ball hyperemic conjunctiva, dropsy. This kind of simple eye prominent already does not feel the ache not to feel the putsation. Clinical often depends on dissects the position to divide into the sphenoid bone ji meningioma 3 parts, namely in lateral either depth portion or processus clinoideus department (in 1/3) tumor, middle (1/3) either winglet department tumor and exterior (1/3) or big wing department tumor. This 3 parts grow the tumor besides above possibly has the common symptom and the symptom, tumor located in lateral, because the tumor extrudes this side IIth, III, IV, V and the VI cranial nerve, therefore the early time may appear carries on the ophthalmoporalysis, the face feels drops, specially the trigeminal or trifacial nerve first distribution area, and may have the vision, the field of vision change. May also present the simple eye vision to drop, sickness side eyeground assumes the primary optic atrophy, the opposite side appears regards the nipple dropsy’s special symptom. Later may have the headache, the hyposmia, the pyramidal tract to draft and so on the neighbor brain organizations or the neck the artery bearing symptom. When this area tumor extrusion basis festival possibly causes the one-sided tremor artuum syndrome, on the head even piece may see that this area has the ossein proliferation or the destruction. The tumor located at the sphenoid bone ji middle (1/3), often grows is very big, when it to temporal lobe extension, may have the energetic symptom, to temporal lobe growth when may cause the temporal lobe hook to return to the outbreak, and has the opposite side facial nerve paralysis or the mobile aphasia, the most patients have the symptom which and the symptom the cerebrospinal fluid pressure advances. The sphenoid bone ji outside 1/3 tumor his/her skull proliferation or the inside is more obvious than in middle, often discovered that nie the front part skull sticks out outward, and may present the temporal lobe epileptic paroxysm, the one-sided protruding eyeballs and other cerebrospinal fluid pressures increases the higher symptom. But cranial nerve barrier and so on unusual oculomotor nerve performance. The cancer lump mainly may create the opposite side to the young man elder with the side blind in one eye.
4. sulcus olfactorius meningioma
Often starts by the dysosmia, the tumor extrudes the optic nerve to present the eyesight fail alternately backward, the eyeground assumes the primary optic atrophy, the field of vision damage, the extraocular muscle paralysis, the protruding eyeballs, has the energetic symptom, on the head even piece possibly has the ossein proliferation or the ossein destruction in the sulcus olfactorius area.
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