Astrocytomas are primary intracranial
tumors derived from astrocyte cells of the brain.
They may arise in the cerebral hemispheres, in the
posterior fossa, in the optic nerve, and rarely,
the spinal cord. In almost half of the cases, the
first symptom of an astrocytoma is the onset of
a focal or generalized seizure. Between 60 to 75%
of patients will have recurrent seizures in the
course of their illness. Headache and signs of increased
intracranial pressure (headache, vomiting) usually
present late in the disease course. A Computed Tomography
(CT) or Magnetic Resonance Imaging (MRI) scan is
necessary to characterize the anatomy of this tumor
(size, location, consistency). Resection of
tumors will generally allow functional survival
for many years. In recent reports, the 5 year survival
has been over 90% with well resected tumors. These
tumors may eventually undergo malignant transformation
in which case radiation therapy or chemotherapy
may be necessary. Astrocytomas often recur even
after treatment and are usually treated similarly
as the initial tumor, with sometimes more aggressive
chemotherapy or radiation therapy. In some rare
cases, the tumor creates two or more cell types,
and treatment may kill one cell type while allowing
the other to become more aggressive and immune to
future treatments.
In children, the tumor is usually located in the
cerebellum and will present with some combination
of vision deterioration (which is typically uncorrectable
by glasses), gait instability, unilateral ataxia,
and signs of increased intracranial pressure (headache,
vomiting). Children with astrocytoma usually have
decreased memory, attention, and motor abilities,
but unaffected intelligence, language, and academic
skills. When metastasis occurs, it can spread via
the lymphatic system, causing death even when the
primary tumor is well controlled.
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