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Cerebellar Neoplasm

Cerebellar Neoplasms


Presentation

  • The pattern of presentation followed by the authors, who are experienced radiology teachers, is similar to the case discussion technique followed during radiology training.[books.google.com]
  • Tumors in this location frequently present with ATAXIA or signs of INTRACRANIAL HYPERTENSION due to obstruction of the fourth ventricle. Common primary cerebellar tumors include fibrillary ASTROCYTOMA and cerebellar HEMANGIOBLASTOMA.[reference.md]
  • Presentation: The most common presentation of posterior fossa tumors in children is symptomatic elevated ICP secondary to obstructive hydrocephalus. Focal signs are less common.[ispn.guide]
  • Older children also present with truncal ataxia, while infants present with increase in head size. CSF seeding is common at presentation and may result in multifocal disease. Imaging Findings.[aocr.org]
Falling
  • Most of ependymomas fall between 1.00 and 1.30 10 3 mm 2 /s.[ajnr.org]
Nausea
  • Woman with headache holding her head (Image: OlgaVolodina/iStock/Getty Images) People with a brain tumor in the cerebellum often experience headaches, nausea and vomiting.[livestrong.com]
  • Brain Stem Glioma Back to top Characteristics Named for its location at the base of the brain Can range from low grade to high grade Occurs most often in children between three and ten years of age, but can occur in adults Symptoms Headaches Nausea Speech[braintumor.org]
  • Some of the most common are Headaches, often in the morning Nausea and vomiting Changes in your ability to talk, hear, or see Problems with balance or walking Problems with thinking or memory Feeling weak or sleepy Changes in your mood or behavior Seizures[icdlist.com]
  • Manifestations may be nonspecific and include the following: Headache Altered mental status Ataxia Nausea Vomiting Weakness Gait disturbance CNS neoplasms also may manifest as follows: Focal seizures Fixed visual changes Speech deficits Focal sensory[emedicine.medscape.com]
  • They cover: headache during increased physical activity, which are typically stronger in the morning; nausea or vomiting (projectile); and blurred vision or double vision.[health.ccm.net]
Diplopia
  • Clinical features include ataxia, headache, nausea, dizzyness, nystagmus, diplopia, papilledema, etc.[icd10data.com]
  • Findings may include the following: Papilledema, which is more prevalent with pediatric brain tumors, reflects an increase in intracranial pressure (ICP) of several days or longer Diplopia may result from displacement or compression of the sixth cranial[emedicine.medscape.com]
  • Most patients present with diplopia and eventually develop complete paralysis of their eyes. Antibodies to the ganglioside GQ1b are associated with Miller Fisher syndrome.[dizziness-and-balance.com]
  • Diplopia Vertigo Peripheral neuropathy (50%) Progression & Course Weeks to Months: Mean 2 to 3 months Eventually non-ambulatory: 70% to 94% Not affected by treatment of neoplasm Survival Reduced Mean: 2 to 11 years Death from neoplasm 50% Dependent on[neuromuscular.wustl.edu]
  • In some cases, a JPA may also be associated with seizures, vision problems such as blurred vision or double vision (diplopia), gradual changes in behavior or mood, and weakness of the arms and legs resulting in coordination difficulties.[rarediseases.org]
Ataxia
  • Tumors in this location frequently present with ATAXIA or signs of INTRACRANIAL HYPERTENSION due to obstruction of the fourth ventricle. Common primary cerebellar tumors include fibrillary ASTROCYTOMA and cerebellar HEMANGIOBLASTOMA.[reference.md]
  • They are often called "ataxias". According to Musselman et al (2014), the prevalence of childhood ataxia is 26/100,000 children. Ataxia is rare compared to cerebral palsy (211/100,00) and autism (620/100,000).[dizziness-and-balance.com]
  • Plasma exchange Ataxia with antibodies to CARP 8 10 Epidemiology: 1 patient; 77 year old female Clinical: Pure cerebellar syndrome Onset: 3 years after neoplasm Ataxia: Limb; Truncal; Gait; Dysarthria Ocular: Horizontal nystagmus Mental status: Normal[neuromuscular.wustl.edu]
  • , hemiparesis or tetraparesis, postural reaction deficits (contralateral most common, ipsilateral if rostral midbrain), dysphagia, cranial nerve deficits (III-XII possible), irregular respiration Cerebellum Cerebellar ataxia, truncal ataxia, hypermetria[vetbook.org]
Nystagmus
  • This patient was very unsteady and had strong positional nystagmus due to removal of her cerebellar nodulus.[dizziness-and-balance.com]
  • Clinical features include ataxia, headache, nausea, dizzyness, nystagmus, diplopia, papilledema, etc.[icd10data.com]
  • […] location Possible clinical signs Cerebrum, thalamus Seizure, behaviour change, altered mental status, circling, pacing, head pressing, head turn, contralateral postural reaction deficits, blindness Brainstem Altered mental status, circling, head tilt, nystagmus[vetbook.org]
  • A JPA in the optic nerve pathways may be associated with loss of vision, degeneration (atrophy) of the optic nerve, papilledema, nystagmus, and protrusion of the eyeball (proptosis).[rarediseases.org]
  • […] pineal tumors Tumors of the occipital lobe specifically may produce homonymous hemianopia or partial visual field deficits Anosmia may occur with frontal lobe tumors Brainstem and cerebellar tumors induce cranial nerve palsies, ataxia, incoordination, nystagmus[emedicine.medscape.com]
Papilledema
  • Findings may include the following: Papilledema, which is more prevalent with pediatric brain tumors, reflects an increase in intracranial pressure (ICP) of several days or longer Diplopia may result from displacement or compression of the sixth cranial[emedicine.medscape.com]
  • Clinical features include ataxia, headache, nausea, dizzyness, nystagmus, diplopia, papilledema, etc.[icd10data.com]
  • […] field testing (see the section on papilledema in Chapter 1 ).[dartmouth.edu]
  • A JPA in the optic nerve pathways may be associated with loss of vision, degeneration (atrophy) of the optic nerve, papilledema, nystagmus, and protrusion of the eyeball (proptosis).[rarediseases.org]
  • Common clinical findings include truncal ataxia and papilledema (due to increased intracranial pressure). Imaging Findings.[aocr.org]
Tremor
  • They cover: uncoordinated movements, gait, balance disorders, tremors, and dizziness , among others.[health.ccm.net]
  • […] or tetraparesis, postural reaction deficits (contralateral most common, ipsilateral if rostral midbrain), dysphagia, cranial nerve deficits (III-XII possible), irregular respiration Cerebellum Cerebellar ataxia, truncal ataxia, hypermetria, intention tremors[vetbook.org]
  • Location - Parafalcine (arising the meningeal layer between the hemispheres of the brain) Common Symptoms - Seizures, lower extremity weakness, headache, personality changes, dementia, increasing apathy, flattening of affect, unsteadiness, tremor.[neurosurgery.ucla.edu]
  • Intention tremors may be present on an attempt to touch an object. A kinetic tremor may be present in motion. The finger-to-nose and heel-to-knee tests are classic tests of hemispheric cerebellar dysfunction.[dizziness-and-balance.com]
  • Patients may also present with ataxic tremor, dysarthria, postural instability, or gait disturbances.[clinicalgate.com]
Vertigo
  • […] include: Weakness of the face and/or arm, and/or leg on one side of the body Numbness in the face, and/or arm, and/or leg on one side of the body Inability to understand spoken language or inability to speak Inability or difficulty writing or reading Vertigo[verywell.com]
  • 63% After starting tumor treatment: 30% May begin with tumor relapse: 20% Ataxia: Trunk & Limb Severe Pancerebellar Trunk & Limb Dysarthria Oculomotor Nystagmus (100%): Rotary or Vertical in 50%; Including downbeating Oscillopsia & Diplopia Diplopia Vertigo[neuromuscular.wustl.edu]
  • Conservative measures were unsuccessful, and she developed vertigo over the next 6 weeks. Magnetic resonance imaging revealed a 3.8- 3.2-cm, well marginated, left-sided mass with surrounding edema (arrow).[aafp.org]
  • It is quite rare that it actually produces vertigo because the slow growth permits ample time for compensation. These tumors are resectable, though larger tumors may leave residual deficit.[dartmouth.edu]

Workup

  • […] include incompatibility with certain medical equipment, longer imaging times (increased risk of motion artifact), and poor visualization of the subarachnoid space Neither CT nor MRI can be used to differentiate tumor recurrence from radionecrosis See Workup[emedicine.medscape.com]
  • Such a workup should include imaging of the chest (via chest x-ray and/or CT scan of the chest) and also CT of the abdomen and pelvis.[clinicalgate.com]
  • Any adult who has a recent onset of seizures, particularly focal seizures, is considered a tumor suspect until adequate neurologic workup proves otherwise. Specific Tumor Types There are many types of tumors that develop intracranially.[dartmouth.edu]
Gliosis
  • They represent focal malformations of cortical development, similar to some forms of cortical dysplasia, and have an abnormal cytoarchitecture which includes large, often bizarre pyramidal cells in a background of gliosis. Tubers are epileptogenic.[neuropathology-web.org]
  • Prognosis: Death in 50% Antigen Ma1 protein 37 and 40 kDa neuronal & testicular germ cell proteins Homology to Ma2 Ma2 protein Tumors: Not uniform Partoid; Breast; Lung (Large cell); Colon Timing: Neoplasms concurrent to 1 year after syndrome Pathology: Gliosis[neuromuscular.wustl.edu]

Treatment

  • Two patients refused any postoperative treatment. One of these had two surgically removed recurrences after 10 and 11 years and died postoperatively from intracranial hemorrhage.[ncbi.nlm.nih.gov]
  • A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer.[cancer.gov]
  • Surgery is the standard treatment.[braintumor.org]
  • See Answer What about a second opinion for brain tumor treatment? Before starting treatment, you might want a second opinion about your diagnosis and treatment plan.[medicinenet.com]
  • Learn more about different treatment options for brain tumors on our Treatment page .[abta.org]

Prognosis

  • These tumors generally have a good prognosis after surgical resection with an 85% to 100% 5-year survival rate. 1, 9, 10 The favorable prognosis in these patients has been attributed to the low-grade nature of cerebellar pilocytic astrocytomas and the[clinicalgate.com]
  • Even then, their prognosis is not uniformly poor.[acnr.co.uk]
  • Prognosis The overall prognosis for children with low-grade gliomas is excellent, with 90% of children alive at 5 years.[childhoodbraintumor.org]
  • Prompt medical attention and aggressive therapy are important for the best prognosis. Continuous follow-up care is essential for a child diagnosed with a brain tumor.[chw.org]

Etiology

  • […] anatomy and histology blood blood supply cerebrospinal fluid chemically induced chemistry classification complications congenital cytology diagnosis diagnostic imaging diet therapy drug therapy economics embryology enzymology epidemiology ethnology etiology[ncbi.nlm.nih.gov]
  • India Source of Support: None, Conflict of Interest: None PMID: 12215704 Keywords: Brain Edema, diagnosis,etiology,therapy,Brain Neoplasms, complications,diagnosis,Drainage, methods,Female, Human, Hydrocephalus, diagnosis,etiology,therapy,Intracranial[jpgmonline.com]
  • Clinical Clues to Nonmalignant Brain Lesions Clinical clues Suggested etiology Abnormalities found on more extensive imaging that are suggestive of an etiology Cysticercosis, fungal infections, sarcoidosis, tuberculosis Chronic fever; recent dental procedure[aafp.org]
  • Myasthenia gravis thymoma association: Up to 10% to 20% Categories : By underlying etiology Immune Immune reactivity to tumor tissue antigen Neoplasm produces antibody No specific immune process identified Metabolic Disorders Electrolyte abnormalities[neuromuscular.wustl.edu]
  • In some instances, however, the symptoms are specific to the etiology. Hemorrhage, which can be parenchymal or extra-axial is the most common cause of intracranial mass lesions and is discussed in Chapter 27.[dartmouth.edu]

Epidemiology

  • […] options Subheadings: analysis anatomy and histology blood blood supply cerebrospinal fluid chemically induced chemistry classification complications congenital cytology diagnosis diagnostic imaging diet therapy drug therapy economics embryology enzymology epidemiology[ncbi.nlm.nih.gov]
  • […] neurolipocytoma, medullocytoma, lipomatous glioneurocytoma First reported in 1978 ( Acta Neuropathol 1978;41:261 ) Considered a mixed neuronal - glial tumor; lipid is apparently due to tumoral lipidization, not adipose metaplasia ( Am J Surg Pathol 2001;25:1551 ) Epidemiology[pathologyoutlines.com]
  • Most importantly, brain tumors are the No. 1 cause of death among all childhood cancers, according to surveillance, epidemiology, and survival data. ( 2 ) Childhood brain tumors represent an anatomically and biologically diverse group of neoplasms that[pedsinreview.aappublications.org]
  • Plasma exchange Ataxia with antibodies to CARP 8 10 Epidemiology: 1 patient; 77 year old female Clinical: Pure cerebellar syndrome Onset: 3 years after neoplasm Ataxia: Limb; Truncal; Gait; Dysarthria Ocular: Horizontal nystagmus Mental status: Normal[neuromuscular.wustl.edu]
  • Epidemiology of brain tumors. Curr Opin Neurol 2000; 13: 635–640. 3. Koeller KK, Rushing EJ. Medulloblastoma: a comprehensive review with radiologic-pathologic correlation. RadioGraphics 2003; 23: 1613-37. 4. Arseni C, Ciurea AV.[aocr.org]
Sex distribution
Age distribution

Pathophysiology

  • Postoperative posterior fossa syndrome: unraveling the etiology and underlying pathophysiology by using magnetic resonance imaging. Childs Nerv Syst. 2015;31(10):1853–8.[bmccancer.biomedcentral.com]

Prevention

  • […] diagnosis diagnostic imaging diet therapy drug therapy economics embryology enzymology epidemiology ethnology etiology genetics history immunology metabolism microbiology mortality nursing organization and administration pathology physiology physiopathology prevention[ncbi.nlm.nih.gov]
  • As the tumour increases in size, the supratentorial pressure build-up increases and prevents as much as possible the encroachment of the brainstem and hypothalamus.[jpgmonline.com]
  • Radiation can shrink the tumor or help prevent it from growing any larger. Radiation can also be used to kill cancer cells if the tumor is malignant. It may also be used on the parts of a tumor the surgeon was unable to remove.[webmd.com]
  • There is nothing you could have done to prevent this from happening.[ucsfbenioffchildrens.org]
  • Chemotherapy Radiation therapy Steroids (to treat and prevent swelling especially in the brain) Anti-seizure medication (to treat and prevent seizures associated with intracranial pressure) Ventriculoperitoneal shunt (Also called a VP shunt) - A VP shunt[chw.org]

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