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Classification of brainstem gliomas by MRI appearance. Histopathology of a brainstem glioma. A brainstem glioma is a cancerous glioma tumor in the brainstem.Around 75% are diagnosed in children and young adults under the age of twenty, but have been known to affect older adults as well. [1]
The treatment approach depends on the site, size and symptoms present, as well as the history of hemorrhage from the lesion. [27] Microsurgery is generally preferred if the cerebral cavernous hemangioma is superficial in the central nervous system, or the risk of damage to surrounding tissue from irradiation is too high.
The symptoms of brain stem tumors vary greatly and can include ataxia, cranial nerve palsy, headaches, problems with speech and swallowing, hearing loss, weakness, hemiparesis, vision abnormalities, ptosis, and behavioral changes. Another possible symptom is vomiting.
Conventional external beam "whole-brain radiotherapy treatment" (WBRT) or "whole-brain irradiation" may be suggested if there is a risk that other secondary tumors will develop in the future. [74] Stereotactic radiotherapy is usually recommended in cases involving fewer than three small secondary brain tumors.
In PRES related to medications, there may be an interval of weeks to months between the initiation of the treatment and the development of PRES. [1] [3] After a hematopoietic stem cell transplantation (bone marrow transplant) the risk of PRES is approximately 8%, whereas the risk is lower (0.4-6%) after a solid organ transplant. [3]
The most common area of involvement is the cortical white matter of frontal and parieto occipital lobes, but lesions may occur anywhere in the brain, such as the basal ganglia, external capsule, and posterior cranial fossa structures such as the brain stem and cerebellum. [12]
Hemangioblastomas usually occur in adults, yet tumors may appear in VHL syndrome at much younger ages. Men and women are approximately at the same risk. Although they can occur in any section of the central nervous system, they usually occur in either side of the cerebellum, the brain stem or the spinal cord. [2] [7]
Pseudobulbar palsy is the result of damage of motor fibers traveling from the cerebral cortex to the lower brain stem. This damage might arise in the course of a variety of neurological conditions that involve demyelination and bilateral corticobulbar lesions. Examples include: [3] Progressive supranuclear palsy