Gliomas
Despite all the advances in radiotherapy, chemotherapy and microsurgical neurosurgery techniques, the median survival of malignant gliomas remains poor. However, in the last decades our knowledge of glioma biology has expanded dramatically. From brain tumour stem cells to antiangiogenic therapies, to real time image guided surgery, the promise of treating brain tumours has never looked so good.
This website is about exploring new therapies. At the same time we will discuss some of the fundamentals of gliomas and review the treatments for which good evidence already exists. We will hopefully do all this contemporaneously.
Gliomas are primary tumours of the central nervous system. They are classified according to the World Health Organization (WHO) classification, from grade I to IV. Grade IV tumours are the most malignant and carry the worst prognosis. Glioblastoma multiforme (GBM) falls under this category and is the main focus of glioma research undertaken worldwide. The median survival after diagnosis and treatment is about 12 months.
Glioblastomas arise from astrocytes and can be categorized as primary or secondary, although usually when the diagnosis is made this distinction is not possible. Primary glioblastomas arise de novo, whereas secondary glioblastomas are a progression of lower grade astrocytomas. At present the only known risk factors for gliomas are inherited genetics disorders and ionizing radiation. However, they account for a small percentage of people who develop gliomas. The identified syndromes include:
- Neurofibromatosis
- Li-Fraumeni
- Turcot's syndrome
Gliomas tend to present with headaches, focal neurological deficits, cognitive impairment, epilepsy or any combination of these. The focal neurological deficits usually predict the anatomical location of the tumour and include:
- Visual impairment
- Loss of strength or sensation on one side
- Difficulty speaking or understanding speech
Typically the headaches and neurological symptoms are progressive. Headaches due to raised intracranial pressure are worse in the morning, on straining (coughing, bending over) and associated with nausea and vomiting. CT or MRI with/without contrast enhancement and subsequent biopsy confirm the diagnosis.
Coming soon!
Radiological evolution of a glioma
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