Ms. Wu from Zhumadian, Henan has been drowsy for more than 20 days. Her family didn’t care at first, but she didn’t expect Ms. Wu to start talking nonsense when she woke up on the second day of the new year. , a few days later, I don’t even know my family. At present, experts have consulted with Ms. Wu, and the examination showed that there is a glioma in the skull, and the specific cause needs to be further confirmed. What is a glioma? What symptoms suggest brain lesions?
Glioma with high malignancy, fast growth and short course of disease
< span>Glioma is the most common primary intracranial malignant tumor, among which, glioblastoma is the most malignant glioma, accounting for half of all gliomas and all primary 15% of brain tumors. Glioma is considered to be one of the most difficult and refractory tumors in neurosurgical treatment due to its high degree of malignancy, rapid growth, short course of disease, easy postoperative recurrence and high disability. Li Wenbin, deputy director of the Glioma Professional Committee of the China Anti-Cancer Association and director of the neurosurgery neurotumor comprehensive treatment ward of Beijing Tiantan Hospital, once pointed out in an interview that brain tumors represented by gliomas are the most difficult cancers in my country. One of the most difficult cancers to overcome. Because there is no particularly significant boundary between gliomas and normal brain tissue, it is difficult to completely remove them by surgery. Compared with other cancer types, gliomas are not sensitive to radiotherapy and chemotherapy, and are prone to recurrence. The overall survival period of patients is particularly short. .
Most glioma patients will experience headache, dizziness, nausea and vomiting, disturbance of consciousness (such as lethargy, confusion, delirium, etc.), epilepsy, One side limb weakness, aphasia, mental disorders and other symptoms. If the above symptoms are accompanied by persistent or intermittent recurrence, it is recommended to perform a cranial MRI examination to exclude the possibility of brain tumors. According to the “Guidelines for the Diagnosis and Treatment of Glioma (2018 Edition)”, it is strongly recommended that the imaging screening of gliomas is mainly based on magnetic resonance (MRI) examinations, supplemented by CT examinations. Relevant data show that MRI examination can not only identify gliomas and some non-tumor lesions, avoid unnecessary surgery, but also help to grade gliomas, detect intraoperative displacement of tumors in real time, clarify the extent of glioma invasion, and help tumors Stereotactic biopsy region selection is helpful for judging the degree of resection and evaluating prognosis of gliomas.
Adolescents and over 40 years of age have a high incidence, and surgery is the main treatment
In recent years, the incidence of glioma has been increasing at an annual rate of 1%-2%, and it is more common in teenagers and people over 40 years old. The cause of glioma is not yet clear, and it is currently believed that some The occurrence of glioma may be related to genetic, radiation, emotional, trauma, viral infection and other factors. Li Wenbin suggested that everyone should maintain regular work and rest to reduce the impact on the immune system, stay away from radiation as much as possible, and maintain a balanced and happy mood.
Because gliomas are generally sensitive to radiotherapy and chemotherapy, surgery-based comprehensive treatment (radiotherapy and chemotherapy, targeted therapy, immune treatment, electric field therapy, etc.) is an effective means to control glioma. Li Wenbin introduced that in clinical practice, surgery is still the main treatment, supplemented by standardized radiotherapy, chemotherapy, and regular review, in order to improve the treatment effect and prolong the survival of patients. However, because it is a tumor that grows in an important part of the human body, it is difficult to achieve cure through surgery. In 2018, the first “Guidelines for Diagnosis and Treatment of Glioma” issued by the National Health and Medical Commission included the tumor electric field treatment plan, which was recommended for new-onset glioblastoma (level 1 evidence) and recurrent high-grade glioma (level 2 evidence). ). Relevant data show that compared with temozolomide (TMZ) chemotherapy alone, tumor electric field therapy combined with TMZ therapy significantly improved the progression-free survival and overall survival of patients, and the five-year overall survival rate of patients increased from 5% to 13%. The median overall survival was extended from 16 months to 20.9 months.
If symptoms such as drowsiness occur, be alert to brain lesions
After excluding environmental factors, physical weakness, and drug factors, if a state of drowsiness occurs, the first thing to consider is whether there is brain disease. Inflammation of the brain, brain tumor, brain atrophy, cerebral arteriosclerosis and cerebrovascular disease, etc., will all cause drowsiness. If you suspect drowsiness caused by brain disease, you should go to the hospital for a detailed examination in time for early diagnosis.
The National Health Commission reminds that if the following symptoms occur without obvious reasons, be alert to the possibility of brain tumors:
● Headache accompanied by nausea and vomiting
The headache is mostly located in the forehead and temporal, and it is persistent Pain, progressive increase, morning light and evening heavy.
●Endocrine disorders
such as blurred vision, Menstrual disorders, infertility, sexual dysfunction, etc.
Symptoms of paralysis
on one or both sides Limb weakness, paralysis, numbness and sensory disturbance.
Epilepsy
manifested as limb convulsions, consciousness Unclear or transient absence, hallucinations, hallucinations, etc.
● Altered mental state of consciousness
such as unresponsiveness , memory, judgment loss, temperament changes, severe cases may appear dementia, coma and so on.
Imaging and laboratory tests are important for diagnosing intracranial lesions, such as CT, magnetic resonance (MRI), whole-brain angiography ( DSA), lumbar puncture, EEG, PET/CT, biopsy, etc. Among them, MRI is the most commonly used and most effective examination method for the detection of brain tumors.
Beijing News reporter Liu Xu Zhang Zhaohui