Obligatory medical device diagnostics. Magnetic resonance imaging of the skull (cranial MRI or cMRI) with intravenous contrast [gold standard]-to exclude brain tumor; also for focal seizures without known CNS pathology (central nervous system disease signs). Computed tomography of the skull (cranial CT or cCT) with intravenous contrast agent – for tumors with calcifications or bone … Brain Tumors: Diagnostic Tests
1st order Brain tumors: If possible, complete resection (surgical removal) of the tumor (by stereotaxy if necessary) [primary treatment of choice]. Brain metastases* : In a limited number of one to three metastases, With a diameter of ≥ 3 cmNote: If a metastasis is not so extensive and has a size of ≤ 3-3.5 cm, … Brain Tumors: Surgical Therapy
To prevent brain tumors, attention must be paid to reducing individual risk factors. Behavioral risk factors Psychosocial situation High earnings – in men, risk increase for glioma by 14%. Overweight (BMI ≥ 25; obesity); higher lifetime probability of developing meningioma: BMI 25-29.9: 21% BMI ≥ 30: 54 Environmental pollution – intoxications (poisonings). Carcinogens Ionizing rays … Brain Tumors: Prevention
Brain tumors cannot always be reliably removed without leaving microscopic residual tumor tissue. Furthermore, there are tumor localizations that make surgical therapy impossible. The goal of radiation therapy in such cases is: To prevent residual tumor tissue from further growth. Treatment of a tumor that cannot be treated surgically because of its location Three concepts … Brain Tumors: Radiotherapy
The following symptoms and complaints may indicate brain tumors: Change in behavior, temperament Aphasia (“speechlessness”) Apraxia – inability to perform purposeful actions. Respiratory disorders Disturbances of consciousness/alterations of consciousness Cephalgia (headache) – new onset; unusual; especially at night and early morning; often improves spontaneously during the day; present as the first and only symptom in … Brain Tumors: Symptoms, Complaints, Signs
Pathogenesis (development of disease) Brain tumors are mostly neuroepithelial in origin. The exact cause of brain tumors is ultimately not yet clear.A genome-wide association study (GWAS) of the most common malignant brain tumor, glioma, has confirmed the histopathologic bifurcation that separates “high-grade” glioblastoma from other “low-grade” gliomas. Etiology (Causes) Biographic causes Genetic burden from parents, … Brain Tumors: Causes
General measures Aim for normal weight! Obesity is a risk factor for meningioma.Determine BMI (body mass index, body mass index) or body composition using electrical impedance analysis and, if necessary, participate in a medically supervised weight loss program. BMI ≥ 25 → participation in a medically supervised weight loss program. Vaccinations The following vaccinations are … Brain Tumors: Therapy
2nd order laboratory parameters – depending on the results of the history, physical examination and obligatory laboratory parameters – for differential diagnostic clarification in disorders of consciousness or brain tumors* . Small blood count Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate). Urine status (rapid test for: pH, leukocytes, nitrite, protein, glucose, … Brain Tumors: Lab Test
Medical history (history of illness) represents an important component in the diagnosis of brain tumors. Family history What is the general health of your family members? Are there any diseases in your family that are common? Are there any hereditary diseases in your family? Social history What is your profession? Are you exposed to harmful … Brain Tumors: Medical History
Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99). Li-Fraumeni syndrome – autosomal dominant inherited disorder leading to multiple tumors (including astrocytomas). Blood, blood-forming organs – immune system (D50-D90). Sarcoidosis (synonyms: Boeck’s disease; Schaumann-Besnier’s disease) – systemic disease of connective tissue with granuloma formation. Cardiovascular system (I00-I99) Chronic subdural hematoma (cSDH) – hematoma (bruise) between the dura … Brain Tumors: Or something else? Differential Diagnosis
The following are the most important diseases or complications that may be contributed to by brain tumors: Cardiovascular system (I00-I99). Venous thromboembolism (VTE; occlusion of a blood vessel by a detached blood clot). Neoplasms – tumor diseases (C00-D48). Hemorrhage into the tumor Psyche – nervous system (F00-F99; G00-G99) Affective disorders (mood disorders) Attention-deficit/hyperactivity disorder (ADHD). … Brain Tumors: Consequential Diseases
Tumors of the central nervous system have previously been classified according to the WHO classification as follows: WHO grade Grade description Diagnoses (exemplary) I Benign (benign) tumors that can usually be cured by surgical removal Craniopharyngeoma, neurinoma, oligodendroglioma, pilocytic astrocytoma,subependymal giant cell astrocytoma,meningiomas* (80% of all meningiomas are considered benign) II Benign (malignant) but often … Brain Tumors: Classification
