The medical history (history of the patient) represents an important component in the diagnosis of gliomas. 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 … Gliomas: 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 … Gliomas: Or something else? Differential Diagnosis
The following are the most important diseases or complications that may be contributed to by gliomas: 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) Epilepsy (seizures) Cognitive disorders … Gliomas: Consequential Diseases
General measures Aim for normal weight! Obesity is a risk factor for meningioma.Determine BMI (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. Chemotherapy May be indicated (indicated) in each case … Gliomas: Therapy
Stereotactically guided serial biopsy based on structural and metabolic imaging (MRI/PET) is used to establish the diagnosis. Primary therapy of gliomas [modified according to]. Gliomas Operation Further Astrocytoma (WHO grade II) Surgery or biopsy and observational waiting (“watchful waiting”) or radiotherapy Pilocytic astrocytoma (WHO grade I) Surgery Anaplastic astrocytoma, oligodendroglioma/oligoastrocytoma (WHO grade III). Surgery (or … Gliomas: Surgical Therapy
To prevent gliomas, attention must be paid to reducing individual risk factors. Behavioral risk factors Psychosocial situation High earnings – in men, risk increase for glioma by 14%. Environmental pollution – intoxications (poisoning). Carcinogens Ionizing rays Further After head and neck CT, the risk of tumors is increased for children. This is especially true for … Gliomas: 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 … Gliomas: Radiotherapy
The following symptoms and complaints may indicate gliomas: Change in behavior, nature 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 only … Gliomas: Symptoms, Complaints, Signs
Pathogenesis (development of disease) Gliomas are neuroepithelial in origin. Ultimately, the exact cause of brain tumors has not been determined. A genome-wide association study (GWAS) of the most common malignant brain tumor, glioma, has confirmed the histopathologic bifurcation that distinguishes “high-grade” glioblastoma from other “low-grade” gliomas. Etiology (Causes) Biographic causes Genetic burden from parents, grandparents … Gliomas: Causes
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 … Gliomas: Classification
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; furthermore: Inspection (viewing). Skin, mucous membranes and sclerae (white part of the eye). Gait pattern [gait disturbances] Ophthalmic examination – including ophthalmoscopy (ophthalmoscopy) of the back of the eye [visual disturbances; papilledema … Gliomas: Examination
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, … Gliomas: Lab Test
