Brain stem gliomas, tumors that start in the cells of the glial of the medulla oblongata, which is the part of the brain connecting to the spinal cord. Healthcare providers determine brain stem gliomas through neurological tests and scans like MRI or CT scans. Medications usually include radiation therapy, chemotherapy, or sometimes surgery to remove the tumor.
Definition
Brain stem gliomas, tumors that start in the medulla oblongata, the brain area directly connected to the spinal.
Gliomas are a type of tumor that can be created in the head. They develop from cells of glial, which assist the neurons that make up the maximum.
Studies indicate that medulla oblongata gliomas are more frequent in children when compared to adults, although the reasons for this are not fully understood by researchers.
Types
Gliomas are classified into 3 main kinds based on the types of cells of the glial they originate from:
- Astrocytomas arise from astrocytes.
- Ependymomas develop from cells of the ependymal.
- Oligodendrogliomas originate from cells of oligodendrocyte.
Healthcare providers also classify gliomas as stated by where they are located in the brain and how they grow.
For example, the NCI (National Cancer Institute) identifies the primary kinds of gliomas that affect children:
- DIPG: These tumors grow rapidly in the pons varolii, the upper part of the medulla oblongata. They can spread quickly to surrounding healthy brain tissue, impacting essential functions like heart rate and breathing.
- Tectal plate Glioma: Unlike DIPG, this type of tumor grows slowly and does not produce in the pons varolii. It typically remains localized and does not extend to other areas of the brain.
Causes
The exact reasons behind pediatric brainstem glioma are not fully understood by experts. However, there is proof suggesting that getting NF1 (neurofibromatosis type 1) can increase the chance of developing this issue.
NF1 is an uncommon genetic disorder that leads to the growth of tumors on the nerves and skin.
A review from 2016 indicated that certain genetic changes, such as those in the HIST1H3B and H3F3A genes, might contribute to the growth of pediatric brainstem glioma. It’s uncertain whether these same mutations are associated with gliomas in adults.
Symptoms
These brain stem gliomas can lead to a wide range of symptoms that are not specific to the condition.
In children, these symptoms may involve:
- Problems with movement of the eye, like eyes turning towards the inside.
- Vision issues.
- Headaches in the morning or headaches that improve after vomiting.
- A sick feeling in the stomach and vomiting.
- Unusual sleepiness.
- Lack of ability to move one-half of the face or body.
- Impaired balance and trouble walking.
- Changes in energy levels.
- Behavioral changes.
- Troubles with learning.
In adults, the most frequent sign of brain stem gliomas is headaches. These symptoms can vary widely depending on the size and place of the tumor within the brain stem.
Diagnosis
Healthcare providers use several methods to diagnose childhood brain stem glioma beyond taking treatment history and conducting a physical test.
A neurological test is crucial, as it evaluates the function of the nervous system and brain. This includes assessing coordination, reflexes, and mental status, which can provide insights into possible abnormalities caused by the tumor.
Another essential diagnostic tool is MRI (magnetic resonance imaging) with gadolinium contrast. This imaging technique produces detailed pictures of the brain, allowing healthcare providers to visualize the tumor more clearly. Gadolinium, an injectable contrast agent, enhances the visibility of the tumor by highlighting the differences between the tumor tissue and normal brain tissue. This helps healthcare providers accurately locate and assess the size and scope of the brain stem glioma.
Treatment
Treating gliomas involves employing various methods tailored to the specific type and stage of the tumor.
Paediatric Diffuse Intrinsic Brain Stem Glioma
As stated by the National Cancer Institute, there is currently no permanent healing for pediatric diffuse intrinsic brain stem glioma. However, the treatment aims to alleviate symptoms and manage the tumor’s growth. Radiation therapy is commonly used, where precise rays of radiation are directed at the tumor to slow its progression. Chemotherapy, involving powerful drugs that target cancer cells, is another approach to manage the condition.
Childhood Tectal plate Glioma
Similar to diffuse intrinsic gliomas, there is no definitive cure for childhood tectal plate glioma. Treatment strategies aim to relieve symptoms and control tumor growth. Surgery may be considered to eliminate the glioma, particularly if it’s slow-growing and accessible without causing significant damage to surrounding brain tissue. Prior to surgery, healthcare providers might suggest radiation therapy and chemotherapy to shrink the tumor and make surgical removal more effective. Radiation therapy, which involves placing small radioactive seeds close to the tumor, is another option to deliver targeted radiation directly to the glioma site.
Adult Brain Stem Tumor
In cases of these gliomas, treatment typically includes chemotherapy and radiation therapy. These therapies are aimed at slowing tumor growth, alleviating symptoms, and improving the quality of life for the patient. The approach may vary depending on the tumor’s place, size, and whether it’s fast- or slow-growing.
Outlook
A study in 2021 reported that, on average, children diagnosed with brain stem tumors survive for about 2 years. This survival time is particularly relevant for children aged 5 to 9 years. The study highlighted that developing a glioma smaller than 3 cm in quantity may enhance prognosis. Surgical removal of the tumor also showed potential for improving outcomes, although the investigation did not identify the same benefits from chemotherapy or radiotherapy.
In adults, according to a 2016 review, the average survival time after a determination of certain types of brain stem tumors ranges from thirty to forty months. However, the outlook tends to deteriorate with age. This suggests that early diagnosis and effective treatment strategies may play critical roles in extending survival and improving the quality of life for individuals with brain stem gliomas.
Summary
Brain stem gliomas are tumors originating from glial cells in the brain stem, affecting both children and adults. Diagnosis involves neurological exams and MRI scans with gadolinium contrast. Treatment varies for children, therapies like radiation and chemotherapy manage symptoms, while surgery may be an option for some.
Adults also undergo radiation and chemotherapy, aiming to slow tumor growth. Prognosis differs by age and tumor size, with children typically surviving around 24 months post-diagnosis, while adults may survive 30 to 40 months, with outcomes worsening with age. Early detection and tailored treatments are crucial for improving outcomes in brain stem gliomas.
