Brainstem Glioma - Causes, Signs, Symptoms, Diagnosis and Treatment

What Is Glioma?

Glioma refers to the type of tumor that is known to occur in the spinal cord and brain. These types of tumors begin in the glial cells that are found surrounding the nerve cells. Glial cells are very helpful for the functioning of the nerves. Once they are affected, several health-related issues occur. Based on the type of glial cell involved, glioma can be categorized into different types. The most important problem associated with any type of glioma is the damages to the functioning of the brain.

What Is Brainstem Glioma?

Brainstem glioma is the type of glioma that is found in the brainstem. It is known to begin from the region of the medulla or midbrain. Nearly twenty percent of the primary brain tumors occurring in young patients are brainstem glioma. In adults, only less than two percent of the cases are noted.

What Is the Epidemiology of Brainstem Glioma?

The analysis of the distribution of a particular condition is studied for a specific population. The brainstem glioma can occur in different ways based on age, gender, and national origin. This condition is known to affect the male gender a lot. People who belong to the young age group are affected more than others.

What Are the Causes of Brainstem Glioma?

The exact cause for brainstem glioma is not identified. Many medical researchers suggest that genetic mutation might cause brainstem glioma. A family history of brainstem glioma can also contribute to the occurrence of this condition.

What Are the Signs and Symptoms of Brainstem Glioma?

The various signs and symptoms associated with brainstem glioma are:

• Weakness.

• Diplopia (double vision).

• Difficulty in swallowing.

• Unsteady gait.

• Headache.

• Dysarthria (difficulty speaking).

• Nausea.

• Drowsiness.

• Behavioral changes in children.

• Vomiting.

• Deterioration of handwriting.

• Seizures.

• Changes in speaking pattern.

The important signs and symptoms that are noted in the clinical examination are disorders of the cranial nerves. Swelling of the region surrounding the eyes is also noted. A sensory loss of the sensations in the facial region is seen in some patients.

How Is Brainstem Glioma Diagnosed?

The various diagnostic procedure for identifying the brainstem glioma are:

• Neurological Examination: In the neurological examination, the doctor will check for balance, strength, hearing, vision, coordination, and functioning of different reflux. Any problems in the areas of the brain can be identified with a neurological examination.

• Magnetic Resonance Imaging (MRI) Scan: This is a very useful tool for diagnosing the tumors of the brain. In certain situations, a contrast dye is injected through the veins in the arms. These dyes help in visualizing the tumors. The different magnetic resonance imaging variations include magnetic resonance spectroscopy, functional magnetic resonance imaging, and perfusion magnetic resonance imaging.

• Biopsy: After identifying the rotation of glioma, a biopsy procedure might be performed before the commencement of the treatment. A needle might be used for this procedure for removing the tumor. In some cases, a part of the brain tumor is removed. For glioma, a stereotactic biopsy with the needle is recommended. This might be used in areas of the brain that are sensitive to operate. The neurosurgeon will drill a hole into the skull to access the tumor. This procedure is often guided by computed tomography or MRI. The collected biopsy is sent for analysis, and microscopic features are identified. The pathologists will also predict the growth rate of the glioma and observe the tumor's physical appearance.

• Computed Tomography (CT) Scan: CT scan is less accurate than the MRI scan. So when the MRI scan results are not sufficient, only then a CT scan is recommended.

• Cerebrospinal Fluid Examination: Cerebrospinal fluid is collected and sent for laboratory diagnosis to identify the pathological problems.

• Arteriography Examination: Arteriography is a radiographic image obtained by a procedure called an arteriogram. In this procedure, the arteries are visualized with the help of dye or contrast material. In this way, any blockages in the arteries can be noted. It is a very useful diagnostic tool for identifying cancerous conditions.

What Are the Treatment Options for Brainstem Glioma?

The different treatment options for brainstem glioma are:

• Chemotherapy: A chemotherapy treatment using chemotherapeutic agents like Temozolomide can help in providing comfort for patients with brainstem glioma. In some patients, Carboplatin and Vincristine are also helpful. The problem with chemotherapy is relapse of the condition. The other medications that are used for brainstem glioma are Thalidomide and Bevacizumab.

• Focal Radiotherapy: It is the most successful treatment option for brainstem glioma. Patients are known to show good stability in health after radiotherapy. Patients who are experiencing neurological symptoms can be treated with radiotherapy treatment. The doses for radiotherapy are conventional and might range from 54 to 60 Gy. Patients who are treated with radiotherapy show a great improvement in the survival rate.

• Surgery: Surgery is always performed in association with chemotherapy and radiation therapy. Removal of the small portion of the tumor can show a drastic change in the reduction of symptoms. The risks associated with surgical options are bleeding and infections.

• Targeted Drug Therapy: The treatment of targeted drugs aims at the abnormalities that are present in the cancer cells. Targeted drug therapy obstructs the abnormality and causes cancer cells to die. The medications are given either through veins or oral routes. The drugs that are given through the veins help in the restriction of the formation of other new blood vessels. As a result, blood circulation to the tumor is lost, and the cancer cells are killed.

In addition to these methods, the patient is also advised for rehabilitation after the treatment. This will help in the development of control over motor skills, vision, thinking, and speech. The methods that are followed for rehabilitation are

• Speech Therapy: Speech pathologists will train the patients who are having difficulty in speaking.

• Occupational Therapy: In occupational therapy, the patient is brought to a health condition where they can perform all the daily routine activities.

• Physical Therapy: This will help in regaining the muscular strength and motor skills that are lost.

Conclusion:

The tumors are located in the parts of the brain that controls critical functions such as breathing, heart rate, and swallowing. So when left untreated, the tumor may begin impairing the critical functions. Hence taking appropriate treatment helps control the tumor growth and prolongs the survival of the patient.