Posted on December 28, 2009.
The tumors of a brain to the children
The tumors of the victory of nervous first central system place on the frequency among the cunning solid tumors to the children, doing 20% of all oncological desease in the age of the children. These tumors arrive the frequency 2-2,8 on 100000 populations of the children, taking the second place among the reasons of death of children with an oncological pathology. The children of fall of age predscolaire sick more often: the summit of desease is necessary for 2-7 years. Although the lethality of parameter of these tumors until surpasses now the parameters of lethality to a lot of cunning processes to the children, the modern therapeutic approaches and the advanced accomplishments in the diagnostic occasions, allowing early to diagnose a tumor and precisely to plan the treatment, allow healing a lot of children.
The etiology of this group of tumors now it is unknown, although there are data of the predisposition of patients for example, with neurofibromatosis, to the event to them glioma a brain. The communication of neurogliocytoma of event to the children with a syndrome basocellular nevus (the defeat of a skin, an abnormality of a skeleton, a leather, a brushes, a feet and a system nervous central abnormalities) is known. The raised desease of tumors of a brain is marked to the children with a congenital immunodeficiency, to the children with the lake ataxia streaks.
Often the tumor of a brain presents itself as the second tumor to the children, suffering leukosis splitting, a hepatocellular cancer, the tumors of adrenocortical. All these data testify to the availability of some causes cotisables for the progress of cunning tumors of a brain, decipher that and define their influence on the this of anticipation is necessary in the future.
The classification of tumors of a brain to the children.
According to the international classification the CART (1990, the second edition) the biological behavior of tumors systems central nervous that it is defined (what's more presence of characteristics of histologic of a differentiation) supposedly, a malevolence of degree or anaplasia: of I (the good quality) in top to IV (cunning). To the tumors degrees low of malevolence belong to the tumor III of a degree (the Low degree), to a high degree of malevolence
- The degrees of iii-iv (the High degree).
The structure of histologic of tumors of a brain to the children significantly differ of those to the adults. Meningiomas, neurilemmomas, the tumors of a hypophysis and the metastasises of the other bodies that often stun rather the brain of adult patients, very rarely to meet at the age of the children. To the children of 70% of tumors done gliomas.
The first classification of tumors of a brain was offered in the twentieth years of our internal Course of century and of Cushing. This classification is based on the fabrics of histogenesis of a brain and the subsequent classifications all has in to the basis this principle.
The tumors of a brain diagnosed for the children of the first years of a life, have central arrangement, c. -a -d. to stun more often the third ventricule, the hypothalamus, chiasm the nerves views, an average brain, the bridge, a cerebellum and the fourth ventricule. Despite the Fact that the volume of substance of a brain of a back center cranial does only the tenth party of all volume of a brain, more than the half of all cunning tumors of a brain to the children is superiorer than 1 tumors of brand of year of a back a cranial center. It principally - neurogliocytoma, cerebellar astrocytoma, gliomas of a trunk of a brain and ependymoma the fourth ventricule,.
Picture clinic.
Generally to speak, any tumor of a brain has the cunning behavior without taking account of him the nature of histologic as his growth arrives in the limited volume, and without taking account of the nature of histologic of a tumor the picture clinic of all tumors of a brain is defined, principally, the location of growth of tumorous, the age and a level of preclinical of development of
The nedoplasmes of system of nervour of Cebtral can cause frustration neurological by the infiltration or direct prelum the normal structures, or acted in mediator, causing in a manner neurolymph of obstruction.
The factor defining symptoms dominating to the children by the tumors of a brain, the pressure of raised intracranial is, in the consequence of that there is a classical triad - a morning headache, vomiting and the drowsiness. Heavy, foresee the headache presents itself rarely to the children, but the this is especially important to do the attention to this complaint. The spasmes - the second symptom on the frequency after a headache, especially to the children with the tumors of suprasternal. Roughly to a quarter of such sick of a spasme are the first demonstration of a tumor. Sometimes these children inhale to incline a head in a party. Imply in the process of a cerebellum can cause the ataxia, nystagmus and of others the frustration of cerebellar.
Diagnosis.
Besides the routine inspections clinics, including the investigation of the ophtalmologiste, to such children should be necessarily first CT and MRT with the head of substance of constraste and a vertebral rope. Especially to the location of a tumor in of return to the this of MRT of center is extremely instructive, as this method has the biggest resolution. These research with the success replaced intrusive procedures - arterial angiography or air ventriculography.
The verification of Histologic of a tumor is necessary, but is time in complicated time because of technical difficulties connected with the location of a tumor, implying in to treat the structures vitalement-importants. Now with gradual ocurrence in the practice of neurosurgeons of a new method good day technical of intervention opedrative - the surgeries of stereotactic begin possible to do the tumors of practically any biopsy location. Sometimes in the communication with the substantial growth of pressure of intracranial by a first operation of step to divert is, that strongly improves the neurological statute of the patient.
The research cedredbrospinale will give liquidates to the un-cerveau the news of the distribution of possible extracratonal of cunning process. In the rare cases of distribution of a tumor for nervous central system limits (for example, to presence neurogliocytoma) executing diagnostic additional actions, as the radio of a thorax, ultrasonic of a cavity of stomach, myelogram is necessary.
