What are the diagnostic steps for glioma

Glioma is a relatively unfamiliar disease. Although most gliomas are not malignant tumors, they can have certain effects on the brain nerves, so early diagnosis and early treatment are very important. Some patients have already developed early symptoms of glioma but have not discovered it themselves. Some patients even go to the hospital for examination only when the symptoms become unbearable. These are not conducive to the treatment of the disease. So what are the diagnostic steps for glioma?

Cerebrospinal fluid examination: Lumbar puncture usually increases pressure. Some tumors, such as those located on the brain surface or in the ventricles, may increase the amount of cerebrospinal fluid protein and white blood cell count. Some tumor cells may be found. However, if the intracranial pressure is significantly increased, lumbar puncture may promote brain herniation. Therefore, it is generally only performed when necessary, such as when it is necessary to distinguish inflammation or bleeding. If the pressure increases significantly, the operation should be cautious and do not release too much cerebrospinal fluid. Mannitol drip is given after surgery and careful observation is required.

Ultrasound examination: It can help determine the side and observe whether there is hydrocephalus. For infants, B-mode ultrasound scans can be performed through the anterior fontanelle to show tumor images and other pathological changes.

Electroencephalogram examination: On the one hand, the electroencephalogram 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.

Radioisotope scanning: Tumors that grow fast and have abundant blood supply have high blood-brain barrier permeability and high isotope absorption rate. For example, glioblastoma multiforme shows isotope concentration images, and there may be low-density areas in the middle due to necrosis and cysts. It is necessary to distinguish it from metastatic tumors based on its shape and multiplicity. More benign gliomas such as astrocytomas have lower concentrations, which are often slightly higher than the surrounding brain tissues, and the images are not clear, and some may be negative findings.

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 identify the disease. In particular, CT scans have the greatest diagnostic value. With intravenous contrast agent enhanced scanning, the positioning accuracy is 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 and displacement of the tumor. However, it still needs to be combined with comprehensive clinical considerations to make a clear diagnosis.

MRI: It is more accurate in diagnosing brain tumors than CT, and the images are clearer. It can detect tiny tumors that CT cannot show.