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This is a subspecialty of medicine that studies the brain and spinal cord neoplasms. These neoplasms are typically dangerous and life threatening. Cancer spreads to the nervous system brain metastasis, compression or direct invasion. Compression from continuous tissues or direct invasion relates to the proximity of the nervous system to other structures such as the lumbosacral plexus, brachial plexus, cranium, base of the skull, vertebral neuroforamina, and pelvic bones.
Risk factors include:
Histology
Tumor location
Blood-brain barrier disruption
Symptoms of Neuroncological conditions include:
Visual impairment
Tissue destruction
Local brain infiltration
Increased intracranial pressure
Cerebral edema
Types of neuroncology tumors
Primary tumors
Malignant astrocytomas
Other astrocytomas
Glioma
Pituitary region tumors
Brain stem gliomas
Germ cell and pineal region tumors
Meningiomas and other meningeal tumors
Medulloblastoma and other primitive neuroectodermal tumors
Oligodendrogliomas: these include anaplastic oligodendroglioma, low-grade oligodendroglioma, and oligoastrocytoma.
Tumors of the optic nerve and chiasm
Primary spinal cord tumors
Primary central nervous system lymphoma
Glioblastoma multiforme
Ependymoma
Pontine glioma
Brain stem tumors
Neuroepithelial tumors
Nerve sheath tumors such as schwannoma, neurofibroma
Metastatic Tumors of the Central Nervous System
Intracranial Metastasi: There are three types of intracranial metastasis namely brain metastasis, leptomeningeal metastasis, and dural metastasis.
Brain metastasis: It can be single or multiple and it involves any part of the brain
Leptomeningeal metastasis: It is commonly a result of lung, breast or melanoma primary tumors
Dural metastasis: It is due to direct invasion or hematogenous spread from a contagious bone
Skull Metastasis: There are two types of skull metastases depending on the general site namely skull base and calvarium. Metastases to the calvarium are usually asymptomatic. Due to the close proximity to vascular structures and cranial nerves, metastases to the skull are symptomatic.
Spinal Metastasis: The spine is usually affected by the metastatic disease which involves the epidural space. This generally occurs as an invasion of paravertebral masses through a neuroforaminal or direct invasion from a vertebral body. Management or treatment of spinal cord metastases is determined by the overall status of the patient’s cancer and if the metastasis is causing epidural spinal cord compression.
Diagnostic procedures
Diagnostic Imaging of the Brain and Spinal Cord: Common imaging studies used in neuroncology include magnetic resonance imaging (MRI) as well as computed tomography (CT). Other imaging techniques used are positron emission tomography (PET), myelography and diagnostic angiography.
Lumbar Puncture (LP) and Cerebrospinal Fluid Analysis (CSF): These tests are used for the evaluation of some metastatic conditions, primary tumors and neurologic complications due to cancer.
Pathologic Diagnosis: This uses biopsies which are surgically obtained to make a histologic diagnosis.
Commonly used treatments in neuroncology
Radiotherapy: This treatment uses ionizing radiation to control or kill malignant cancer cells.
Chemotherapy: This is a type of cancer treatment that uses drugs to kill cancer cells.
Corticosteroids
Neurosurgical Interventions
Neurologic complications of cancer
Neuroncological conditions can cause the following complications.
Complications of cancer therapy such as neuropathies related to chemotherapy
Seizures related to cancer
Paraneoplastic Syndromes such as myasthenia gravis, limbic encephalitis
Opportunistic Infections
Stroke in Cancer Patients
About Neuroncology
Key facts to plan your treatment: how long it takes, your hospital stay, anaesthesia, risks and recovery.
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