Diagnostic basis of glioma

In life, eating whole grains, getting sick is inevitable, colds and fevers are common, but we have to be careful if we have a tumor, especially a malignant tumor like glioma. What is the basis for the diagnosis of glioma? Let's take a look!

Many patients have experienced a series of symptoms such as headache and vomiting but have not yet gone to the hospital for examination and diagnosis. At this time, you need to be alert to whether you have already suffered from brain glioma, because the main characteristics of brain glioma are headache, nausea, vomiting, headache mostly located in the forehead and temporal area, and persistent headache paroxysmal aggravation, often more severe in the morning, and normal in the interval period. So how do we generally diagnose glioma clinically?

1. MRI: It is more accurate than CT in diagnosing brain tumors, and the images are clearer. It can detect tiny tumors that CT cannot show. Positron emission tomography can obtain images similar to CT, and can observe the growth and metabolism of tumors and distinguish benign from malignant tumors.

2. Cerebrospinal fluid examination: The pressure of lumbar puncture is usually increased. For some tumors, such as those located on the brain surface or in the ventricles, the amount of cerebrospinal fluid protein may increase, the number of white blood cells may also increase, and some tumor cells may be found. However, for those with significantly increased intracranial pressure, lumbar puncture has the risk of promoting brain herniation. Therefore, it is generally only performed when necessary, such as when it is necessary to distinguish from inflammation or bleeding. For those with obvious pressure increase, the operation should be cautious and do not release too much cerebrospinal fluid. Mannitol drip is given after surgery and careful observation is required.

3. Radiological examination: including skull plain film, ventriculography, computer tomography, etc. Skull plain film can show signs of increased intracranial pressure, tumor calcification and displacement of pineal calcification, etc. Ventriculography can show cerebral vascular displacement and tumor vascular conditions, etc. These abnormal changes are different in different types of tumors in different locations, which can help locate and sometimes even qualitatively determine the diagnosis. In particular, CT scans have the greatest diagnostic value. The intravenous injection of contrast agent enhanced scanning has a positioning accuracy of almost 100%, and the qualitative diagnosis accuracy can reach more than 90%. It can show the location, range, shape, brain tissue reaction, and ventricle compression displacement of the tumor. However, it still needs to be combined with comprehensive clinical considerations to make a clear diagnosis.

4. EEG examination: On the one hand, the EEG changes of gliomas are limited to the changes in brain waves at the tumor site. On the other hand, there are general and widely distributed changes in frequency and amplitude. These are affected by the size of the tumor, infiltration, degree of brain edema, and increased intracranial pressure. Shallow tumors are prone to localized abnormalities, while deep tumors have fewer localized changes. In more benign astrocytomas, oligodendrogliomas, etc., localized delta waves are mainly manifested, and some epileptic waveforms such as spikes or sharp waves can be seen. Large glioblastoma multiforme can show extensive delta waves, which can sometimes only be determined on one side.