亮绿色神经元的大脑图解
亮绿色神经元的大脑图解
亮绿色神经元的大脑图解

脑肿瘤和脑癌

什么是脑瘤?

A brain tumor is a growth of abnormal cells in the brain. The 大脑解剖 是不是很复杂,不同的部分负责不同的神经系统功能. Brain tumors can develop in any 大脑的一部分 or skull, 包括它的保护衬里, 大脑的底部(skull base), the brainstem, the sinuses and the nasal cavity, and many other areas. 有超过120种不同的 可能在脑部发展的肿瘤类型,这取决于它们来自什么组织.

How common are brain tumors, and are they dangerous?

在美国,每10万人中就有30人患有脑部和神经系统肿瘤. 脑肿瘤是危险的,因为它们可以对大脑的健康部位施加压力或扩散到这些区域. Some brain tumors can also be cancerous or become cancerous. They can cause problems if they block the flow of fluid around the brain, which can lead to an increase in pressure inside the skull. 某些类型的肿瘤可以通过脊髓液扩散到大脑或脊柱的远处区域.

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肿瘤和脑部病变有什么不同?

A brain tumor is a specific type of brain lesion. 病灶是指任何组织受损的区域. All tumors are lesions, but not all lesions are tumors. 其他脑部损伤可能由 stroke, injury, encephalitis and 动静脉畸形.

脑瘤vs脑瘤. Brain Cancer

All brain cancers are tumors, but not all brain tumors are cancerous. Noncancerous brain tumors are called benign brain tumors.

良性脑肿瘤通常生长缓慢,边界清晰,很少扩散. 良性肿瘤仍然是危险的. They can damage and compress parts of the brain, causing severe dysfunction. 良性脑瘤位于大脑的重要区域,可能危及生命. Very rarely, a benign tumor can become malignant. 典型的良性肿瘤包括 meningioma, 前庭神经鞘瘤 垂体腺瘤.

恶性脑瘤是癌变的. They typically grow rapidly and invade surrounding healthy brain structures. 脑癌可能会危及生命,因为它会改变大脑的重要结构. 一些起源于大脑或大脑附近的恶性肿瘤包括 嗅觉神经母细胞瘤, chondrosarcoma and 成神经管细胞瘤.

Primary vs. 转移性脑肿瘤

Primary brain tumors are tumors that start in the brain. 最常起源于脑部的肿瘤包括脑膜瘤和神经胶质瘤. 极少数情况下,这些肿瘤会脱落并扩散到大脑和脊髓的其他部位. More commonly, tumors spread to the brain from other parts of the body.

转移性脑肿瘤, 也被称为继发性脑瘤, 恶性肿瘤起源于身体其他部位的癌症,然后转移(扩散)到大脑吗. 转移性脑瘤的发病率是原发性脑瘤的四倍. They can grow rapidly, crowding or invading nearby brain tissue.

Common cancers that can spread to the brain are:

脑肿瘤部位

脑瘤可以在任何地方形成 大脑的一部分, but there are certain regions where specific tumors form:

Other brain tumors are described by the kinds of cells they are made of. For instance, gliomas are composed of glial cells.

Learn more about these and other brain tumor types.

儿童脑肿瘤

Brain tumors are the most common solid tumor in children and adolescents, 影响约5人,美国有1万名儿童.S. each year. 儿童可发生几种不同类型的脑肿瘤,包括星形细胞瘤.g., glioblastoma multiforme), gliomas, ependymomas and 成神经管细胞瘤s.

了解更多关于儿童脑肿瘤的知识.

脑肿瘤症状

Different parts of the brain control different functions, so brain tumor symptoms will vary depending on the tumor’s location. For example, 位于脑后小脑的脑瘤可能导致运动障碍, walking, 平衡与协调. 如果肿瘤影响到负责视觉的视神经通路,可能会发生视力变化.

肿瘤的大小和生长速度也会影响患者的症状.

In general, the most common symptoms of a brain tumor may include:

  • Headaches
  • Seizures 或抽搐
  • 思考、说话或找词困难
  • 性格或行为的改变
  • Weakness, numbness or paralysis in one part or one side of the body
  • 失去平衡、头晕或不稳
  • 听力丧失
  • Vision changes
  • 困惑和迷失方向
  • Memory loss

Diagram of five separate sections of the brain and their associated symptoms. The frontal lobe affects personality, movement and sense of smell. 顶叶影响物体识别, pain and touch, 身体导航和空间位置. 枕叶与视觉有关. 髓质控制着心脏和肺. The pons is responsible for face and eye movement. The temporal lobe is responsible for memory, speech and musical rhythm.

脑瘤能没有症状吗?

脑瘤并不总是会引起症状. In fact, 成人中最常见的脑肿瘤, meningioma, 通常生长缓慢而不被注意. 肿瘤可能不会开始引起症状,直到它们变大到足以干扰大脑内的健康组织.

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脑肿瘤的病因和危险因素

Doctors don’t know why some cells begin to form into tumor cells. 这可能与一个人的基因或环境有关,或者两者兼而有之. Some potential brain tumor causes and risk factors may include:

  • 从身体其他部位扩散的癌症
  • 某些基因状况使人容易产生过多的细胞
  • 暴露在某种形式的辐射下

脑肿瘤是遗传性的吗??

Genetics are to blame for a small number (fewer than 5%) of brain tumors. 一些遗传疾病使个体患肿瘤的风险更大,包括:

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脑肿瘤诊断

Diagnosing a brain tumor usually involves a neurological exam, 脑部扫描和活检, 如果可以安全地完成.

  • 神经系统检查可能包括各种评估神经功能的测试,如平衡, hearing, 视觉和反射.
  • 各种成像技术,包括 CT(或CAT)扫描, MRI, occasionally an angiogram or X-rays can be used to identify the tumor, pinpoint its location and/or assess the function of your brain.
  • 如果医生不能安全地进行手术 biopsy (组织样本采集及分析), 他们将根据其他测试结果诊断脑肿瘤并计划治疗. 如果可能的话, doctors can use it to determine the tumor grade (how aggressive it is), 同时研究肿瘤组织的任何生物标志物,可以帮助个性化的治疗方法.

取决于你的症状, 医生也可以做这些检查来帮助确诊和排除其他疾病:

  • 腰椎穿刺 采集脑脊液样本看是否含有肿瘤细胞的痕迹.
  • 诱发电位研究 to measure electrical activity in the nerves and/or 脑电图(EEG) 来测量大脑的电活动.
  • 神经认知评估,以评估认知和幸福感的任何变化.
  • 神经眼科检查评估影响眼睛的肿瘤征象.
  • Endocrinological evaluation to assess hormone function.

Proper diagnosis is essential in determining the best course of treatment.

脑肿瘤分级

The grade of a brain tumor defines how serious it is. Using the biopsy 作为样本,病理学家将在显微镜下检查肿瘤以确定其级别. 脑肿瘤分级是一种描述脑肿瘤细胞的分类系统,表明肿瘤生长和扩散的可能性.

脑肿瘤分级使用从1(最不具侵袭性)到4(最具侵袭性)的等级。.

(世界卫生组织肿瘤分级系统)

一级脑肿瘤

  • 良性(非癌变)
  • Slow-growing
  • 细胞在显微镜下看起来几乎正常
  • 通常与长期生存有关
  • Rare in adults

二级脑肿瘤

  • 相对增长缓慢
  • Sometimes spreads to nearby normal tissue and comes back (recurs)
  • 细胞在显微镜下看起来有点不正常
  • 有时会复发为恶性肿瘤

III级脑肿瘤

  • 恶性肿瘤(癌)
  • 活跃地繁殖异常细胞
  • Tumor spreads into nearby normal parts of the brain
  • 细胞在显微镜下看起来不正常
  • Tends to come back, often as a higher grade tumor

四级脑肿瘤

  • Malignant
  • 最积极的
  • Grows fast
  • Easily spreads into nearby normal parts of the brain
  • 活跃地繁殖异常细胞
  • 细胞在显微镜下看起来很不正常
  • Tumor forms new blood vessels to maintain rapid growth
  • Tumors have areas of dead cells in their center (called necrosis)

不断变化的诊断

脑肿瘤的级别可能会改变,通常是更高的级别,通常没有原因. 也有可能活检样本不能代表整个肿瘤, 分数的初始数据不准确.

从低级别肿瘤到高级别肿瘤的转变在成人中比在儿童中更常见.

脑肿瘤分期

分期是指肿瘤扩散的程度. If a tumor has migrated to other parts of the body, it has metastasized. Staging is often done for other types of tumors but not 原发性脑瘤. 这是因为脑瘤不太可能扩散到神经系统之外.

相反,其他类型的肿瘤(如.g.肺癌)可以扩散到脑部. Tumors that have spread to the brain are advanced stage.

脑瘤的大小意味着什么?

因为较大的肿瘤更容易干扰正常的大脑功能, 它们通常会引起症状和并发症.

脑肿瘤治疗

The most common treatment for brain tumors is surgery. 对于某些肿瘤,手术切除和持续监测可能是唯一需要的治疗方法. Common surgical approaches to brain tumor removal include craniotomy, neuroendoscopy, laser ablation and 激光间质热疗法.

化疗和放射疗法可以通过缩小肿瘤来治疗脑癌, slowing down its growth and/or preventing it from coming back. 外束放射治疗, 立体定向放射治疗 and 质子治疗 are some of the radiation treatments for brain tumor.

Learn more about these and other brain tumor treatment options.

约翰霍普金斯脑肿瘤中心

Dr. 亨利·布莱姆站在核磁共振成像仪前.

约翰霍普金斯综合脑肿瘤中心是世界上最大的脑肿瘤治疗和研究中心之一. We tailor each patient's treatment using an array of advanced approaches, 包括肿瘤治疗领域和核磁共振引导激光消融等新兴疗法.

脑肿瘤预后

脑瘤可能是一种可怕的诊断. 与您信任的医疗团队合作以确定最佳的下一步措施是很重要的, 无论是观察, surgery, 放射治疗或其他治疗. 你的个人成就有多成功取决于很多因素,包括:

  • The type of brain tumor, its size, grade and location
  • Whether the tumor has spread within the brain or to other parts of the body
  • 你的年龄和整体健康状况
  • How long you had symptoms before you were diagnosed with a brain tumor
  • How much the brain tumor affects your ability to function
  • 你的治疗偏好
  • 你的治疗团队的专业知识

There is no projected survival rate for those diagnosed with a brain tumor, 因为个人情况起着很大的作用. 例如,一些恶性肿瘤可以通过放射治疗成功地控制. 其他的,由于它们的位置,即使是良性的,也可能危及生命. 医生必须观察数千名具有相似特征的患者,以了解某些肿瘤的发展趋势,以及不同的治疗方法对它们的影响.

你的整体前景和预后可能会随着你接受各种治疗而改变. 如果你做了手术, 神经外科医生能切除多少肿瘤会影响接下来发生的事情. Other brain tumor treatments will determine future steps as well.

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