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intracranial_tumor

Intracranial tumor

Tumor in the intracranial compartment.

see Supratentorial tumor

see Brain tumor

see Pediatric intracranial tumor

see Posterior fossa tumor

World Health Organization Classification of Tumors of the Central Nervous System.


Approximately 20% of pediatric intracranial tumors arise from the thalamus or brainstem, with an incidence rate of 5% and 15%, respectively.


Excluding autopsy data, meningiomas comprise approximately 22% of primary intracranial tumors.

Olfactory groove meningiomas can grow insidiously large and present as one of the largest intracranial tumors.


Conventional white matter (WM) imaging approaches, such as diffusion tensor imaging (DTI), have been used to preoperatively identify the location of affected WM tracts in patients with intracranial tumors in order to maximize the extent of resection and potentially reduce postoperative morbidity.

Treatment

Operative resection.

Gamma Knife radiosurgery (GKRS) allows for the treatment of intracranial tumors with a high degree of dose conformality and precision. There are, however, certain situations wherein the dose conformality of GKRS is desired, but single-session treatment is contraindicated. In these situations, a traditional pin-based GKRS head frame cannot be used, because it precludes fractionated treatment.

Complications

The overall complication rate was infection, 2.1%; hematoma, 0.8%; neurologic deterioration, 2.9%; and death, 0.8%. These results compare favorably with published series 1).

Quality of Life

Traditionally, the dominant (usually left) cerebral hemisphere is regarded as the more important one, and everyday clinical decisions are influenced by this view.

The lack of a substantial number of recent, robust follow-up studies investigating the Quality of Life (QoL) in patients at different stages of disease and treatment indicates that more research is needed. Relevance to clinical practice. Understanding the QoL in patients with brain neoplasm and the differences between right and left hemisphere sites of the neoplasm can help nurses develop different interventions and offer more guidance for effective clinical intervention 2).

In an overall patient-reported QOL perspective, tumor laterality does not appear to be of significant importance for generic HRQOL in patients with intracranial tumors. This may imply that right-sided cerebral functions are underestimated by clinicians 3).

Depression

Depression as well as anxious and OCD psychopathology were shown to be prevalent signs among patients with intracranial tumor. Diagnosis of symptoms were totally based on DSM-IV criteria and these disorders and the percentiles don't seem to be related to each other. Due to high variability of tumor stages, statistical analysis of whether the mentioned psychiatric symptoms get worsen at the later stages of the tumor genesis was not feasible. Although not measured directly, psychiatric symptoms seem to get worsen at the later stages of the brain tumor. The associated factors are tumor location, patient's premorbid psychiatric status, cognitive symptoms and adaptive or maladaptive response to stress 4).


Patients with intracranial tumors suffer from decreased Health related quality of life (HRQoL) and suicidal ideation (SI) regardless of histopathology. SI is associated with higher Beck Depression Inventory (BDI) scores, but not evident depression (BDI ≥ 18). Thus, patients should be screened specifically and regularly. Lower HRQoL and greatest prevalence of SI at 6 months may help clinicians to find the right time for careful monitoring of patients at risk 5).

1)
Sajjad J, Kaliaperumal C, Yousaf I, Bhatti RJ, O'Sullivan M. A Prospective Analysis of Complications of Intracranial Tumor Surgery. J Neurol Surg A Cent Eur Neurosurg. 2016 Jul 14. [Epub ahead of print] PubMed PMID: 27415593.
2)
Palese A, Lamanna F, Di Monte C, Calligaris S, Doretto M, Criveller M. Quality of life in patients with right- or left-sided brain tumours: literature review. J Clin Nurs. 2008 Jun;17(11):1403-10. doi: 10.1111/j.1365-2702.2007.02182.x. Review. PubMed PMID: 18482138.
3)
Drewes C, Sagberg LM, Jakola AS, Solheim O. Quality of life in patients with intracranial tumors: does tumor laterality matter? J Neurosurg. 2016 Dec;125(6):1400-1407. PubMed PMID: 27015402.
4)
Seddighi A, Seddighi AS, Nikouei A, Ashrafi F, Nohesara S. Psychological aspects in brain tumor patients: A prospective study. Hell J Nucl Med. 2015 Sep-Dec;18 Suppl 1:63-67. PubMed PMID: 26665213.
5)
Hickmann AK, Nadji-Ohl M, Haug M, Hopf NJ, Ganslandt O, Giese A, Renovanz M. Suicidal ideation, depression, and health-related quality of life in patients with benign and malignant brain tumors: a prospective observational study in 83 patients. Acta Neurochir (Wien). 2016 Sep;158(9):1669-82. doi: 10.1007/s00701-016-2844-y. Epub 2016 Jun 18. PubMed PMID: 27318813.
intracranial_tumor.txt · Last modified: 2017/06/23 09:48 by administrador