Менингиома у детей

MENINGIOMA IN CHILDREN IN THE REPUBLIC OF TAJIKISTAN

OBIDOV HUSEIN HOSHIMOVICH

TAJIK STATE MEDICAL UNIVERSITY BY NAME ABUALI IBNI SINO

Аннотация

В данной статье расматриваються современные диагностики и лечение менингиомы в Республики Таджикистана а также факторы риска которые повышают риск развития данного опухола.Своевременние профилактики доброкачественной менингиомы, прогноз после лечение.

Ключевые слова: современные диагностики и лечение менингиомы,послеоперационный выживаемость,общий и местный симптом менингиомы.

Аnnotation

This article examines modern diagnostics and treatment of meningioma in the Republic of Tajikistan, as well as risk factors that increase the risk of developing this tumor. Timely prevention of benign meningioma , prognosis after treatment.

Key words: modern diagnostics and treatment of meningioma, postoperative survival, general and local symptoms of meningioma .

Meningioma is a benign tumor that develops from cells of the dura mater. Most often, hemangioma affects the brain, but can also develop in the spinal cord. Meningioma is the most common benign tumor of the brain. Recently in the Republic of Tajikistan, their number has decreased than other tumors .

Despite the fact that meningioma is a benign tumor, it still poses a danger to the health and life of the child. Increasing in size, the tumor leads to increased intracranial pressure and compression of the delicate structures of the brain. Such tumors require immediate neurosurgical treatment, as they lead to a significant decrease in the child’s quality of life, and sometimes can even cause death.

Meningiomas mainly affect adults, most often affecting women aged 40-50 years. Sometimes a patient may have more than one tumor. Meningiomas in children are a relatively rare disease and are more common in boys. In children, the intraventricular localization of this tumor predominates , in contrast to adults. One patient in 2015, whose name is called Umar, was diagnosed with intraventricular meningioma. The patient was admitted later; before that, the meningioma had developed in a large size and chemotherapy was given for 2 weeks, with no effect. Then they sent Umara to the Burdenko Neurosurgical Center in Moscow, where they were treated surgically

without craniotomy with endonasal way. The operation was successful and the doctors saved Umaru, but after the operation during the recovery process he had impaired vision and coordination of movement, and after 3 months it all went away. The Republic of Tajikistan does not have a rehabilitation center, but they planned to create a rehabilitation center for the recovery of all patients before and postoperative.

Meningitis tumors can develop in various parts of the brain and even the spinal cord from the arachnoid mater. That is, these formations are classified as a brain tumor, but over time, cell growth rapidly picks up pace and begins to pose a serious danger: pressure on the skull; swelling; pain in the head; dizziness .

Common symptoms of meningioma include headaches, seizures, vision changes and limb weakness. The decision to have surgery often depends on the size of the tumor, its location, and the patient's overall health.

Risk factors

A list of factors that can increase the risk of neoplasm has been established:

Female. Any hormonal fluctuations in the body (during treatment for breast cancer, during pregnancy) affect the development of meningioma .

Age factor. Tumors are registered in patients over 50-60 years of age. In children, the pathology is diagnosed extremely rarely.

Hereditary predisposition. A defect in chromosome 22 affects the development of meningioma . Especially if patients have the neurofibromatosis gene . Gene defects provoke tumors in every second patient.

Negative external influences: intoxication of the body, radiation exposure, mechanical damage to the head area.

Symptoms of meningioma

With small sizes, there may be no clinical symptoms at all. Changes in well-being become noticeable when compression of the brain substance begins. Manifestations depend on location. All symptoms can be divided into general, caused by the presence of additional tissue in the skull, and local, caused by compression of a specific brain structure.

-dizziness ;

-convulsive attacks;

-memory impairment;

-fluctuations in blood pressure; -nausea or vomiting;

-diffuse (spread) headache;

-movement disorders;

-asymmetry and numbness of the face;

-disturbances of consciousness of varying degrees - from confusion to deep deafness;

-muscle weakness;

-behavioral disorders - untidiness, mood swings, apathy, aggressiveness, previously not characteristic of a person;

-change in gait;

-changes in handwriting and writing disorders.

-in the area of the sella turcica - visual impairment in the form of blurriness, decreased acuity, visual disturbances at dusk, limited visual fields or complete blindness (amaurosis);

-in the posterior cranial fossa – hearing loss;

-in the frontal lobe of the hemisphere - changes in the sense of smell or its loss, intellectual decline, thinking disorders;

-cerebellar meningioma – loss of coordination and inability to make precise movements (get a key into a lock, fasten a button);

-temporal lobe – severe memory loss, seizures.

Clinical symptoms increase slowly and gradually, masquerading as natural agerelated disorders in elderly patients.

Modern diagnostics of meningioma in the Republic of Tajikistan:

Preoperative diagnosis of meningioma:

Magnetic resonance imaging (MRI) of the brain with contrast enhancement, which determines the size, location and contours of the meningioma with the area of contrast accumulation. To determine the sources and extent of blood supply to meningioma, MSCT angiography is performed. CT of the brain is a non-invasive diagnostic study that provides greater clarity of the localization of meningioma. Tumor markers are studied .

Intraoperative diagnostics:

Pathomorphologically, meningiomas are diagnosed based on the microscopic picture and data from immunohistochemical studies. There is also intraoperative diagnosis with fluracent .

Express histology, which provides intraoperative clarification of the exact boundaries of the tumor, which is carried out within 15-20 minutes.

Targeted electromagnetic imaging using radiation.

Label free - does not involve the use of certain markers to determine the boundaries based on tissue changes that develop with meningioma .

Treatment of meningioma

There are several methods for treating the disease, but not all of them are used in the Republic of Tajikistan:

surgical removal of meningioma - surgery allows you to remove the formation, but can be very traumatic for the patient. The outcome of the operation will depend on the proximity of the tumor to vital brain structures. With benign forms, it is usually possible to achieve a complete cure.

classical radiation therapy is ineffective in treating tumors. When used, adjacent areas of the brain and spinal cord may be damaged due to spinal tumors. Sometimes used in conjunction 1with surgical excision to remove lesions in inoperable areas or reduce the risk of recurrence.

Radiation therapy using the CyberKnife device is a modern and low-traumatic method of treating tumors up to 3.5-4 cm in size. The tumor is exposed to a directed flow of ionizing radiation. The surrounding tissues are practically not injured.

Prognosis and prevention

The prognosis is favorable if the tumor is benign, is detected and removed in time, and has not grown into neighboring tissues. In this case, a complete recovery is possible.

Recurrence of the tumor occurs in 3% of cases. Atypical meningiomas recur in 40%, malignant tumors in 75-80% of patients. In this case, the five-year survival rate is 30%.

It is necessary to undergo a scheduled MRI with contrast on time: once a year, in order to monitor the dynamics of the pathological process.

It is important to control weight, normalize physical activity and calorie content of meals, and fill the diet with herbs, vegetables, berries, and fruits.

Literature:

Литература:

Ступак В.В., Бузунов А.В., Струц С.Г., Рабинович Е.С. Отдаленные результаты хирургического лечения парасагиттальных менингиом головного мозга // Современные проблемы науки и образования. — 2015. — № 5.

Тиглиев, Г. С. Внутричерепные менингиомы / Г. С. Тиглиев, В. Е. Олюшин, А. Н. Кондратьев. СПб., 2001. 560 с.

Чудакова И.В., Григорьева В.Н. Качество жизни больных с менингиомами головного мозга до и после оперативного лечения // Бюллетень сибирской медицины. Тематический выпуск. — 2009. — № 1 (2). С. 90-94.