Cerebellum tumors should be examined under two separate headings as adults and childhood. Approximately 70-75% of adult brain tumors are located in the brain, while 60-70% of childhood brain tumors are located in the cerebellum. In other words, 2/3 of all adult brain tumors are seen in the brain, while 2/3 of childhood brain tumors are seen in the cerebellum. While the most common brain tumors in adults are glial tumors (astrocytomas), the most common cerebellum tumors are hemangioblatomas with well-known genetic inheritance. The most common tumor after childhood leukemia is cerebellum tumors. The most common among childhood cerebellum tumors (medulloblastoma, astrocytoma, epandioma, brain stem gliomas, dermoid and epidermoid cysts, etc.). Among the adult cerebellum tumors, the most common ones especially in the pontocerbellar corner region in adults (Schwannoma, meningioma, arachnoid and epidermoid cysts, plasmacytomas, glomus jugulare tumors, metastases, etc.)
CYSTIC CEREBELLAR ASTROCYTOMY (980098002) They constitute an average of 10-20% of childhood brain tumors. It is most common in the first 5 years of life. There is no difference between the incidence of men and women. Cystic cerebellar astrocytomas in children have a good prognosis. Certainly these children outperform those with other cerebellum tumors, medulloblastoma, ependymomas, and lesions with brainstem glioma. All these tumors have long-term survival rates when removed. Because only 5-20% of these lesions are histologically malignant.
History of the Disease
Most of these children have the onset of morning headache and vomiting for several weeks. These complaints are tried to be treated with the preliminary diagnosis of other diseases, without ever considering a cerebellum tumor in the beginning. These leading complaints become persistent and persistent over time.
Complaints and Findings
In these children, first of all, personality changes, abnormal gait, double vision and changes in consciousness level occur. Neck pain, slowed heart rate (bradycardia), decreased breathing frequency (bradypnea), hypertension complaints and symptoms develop due to increased pressure in the brain stem. Blurring and closure always indicate a poor prognosis. Increased pressure in the eyes (papilledema) and sometimes optic atrophy are seen. 6th cranial nerve palsy due to increased intracranial pressure (CIBA) is seen in approximately 15% of these patients. Contrary to this, dizziness and other cranial nerve palsies are rarely seen. Truncal ataxia is common. In older children, there is a tandem gait, although it is suspicious. Dysmetria is common in older children. Nystagmus is less common. Cerebellar fits is a rarer condition.
Diagnosis
As with all cerebellum tumors, medicated brain Magnetig Resonance (MR) technique, one of the brain imaging methods, is a very important and reliable noninvasive test method in the diagnosis of these lesions. Apart from this, the medicated brain Computed Tomography (CT) technique provides additional additional information compared to the MR technique in showing whether there are calcifications in the lesion in some tumors such as ependymoma, cystic cerebellar astrocytomas. The cerebrovascular angiography test method has no place in the diagnosis of these lesions. However, cerebrovascular angiography should be performed in those who are thought to have von-Hippel Lindou disease. With this test, it shows the vascular pathologies around the tumor. As a result, when a cerebellum tumor is considered, the diagnosis is made very quickly, quickly and reliably with today’s advanced diagnostic methods. Unfortunately, there are no blood tumor marker tests for the diagnosis of cystic cerebellar astrocytomas in the cerebellum.
In the differential diagnosis, von-Hippel lindau disease, especially with a cystic component, should be kept in mind.
Treatment
As with all cerebellar tumors, if the doctor thinks that the cerebellar lesion is a cystic cerebellar astrocytoma preoperatively, he or she should only rule out von-Hippel-lindou disease. In the treatment strategy of cystic cerebellar astrocytomas, the entire lesion should be surgically removed, if possible. An experienced surgeon manages the surgery by knowing where such a lesion originates and where it grows during cerebellum surgery. Because the vital functions of all anatomical tissues are important during surgery for cerebellum tumors. In cystic cerebellar astrocytomas, especially the yellow colored cystic fluid in the cyst is the characteristic of these tumors. In addition, solitary tumors accompanying the cystic part are usually non-bleeding, soft lesions. If the histopathological report confirms a low grade atrocytoma after all solitary tumor removal, no additional adjuvant radiotherapy or chemotherapy is required for treatment. However, if the malignant type of histopathological astrocytoma is reported, adjuvant radiotherapy and chemotherapy are required in the postoperative period.
Conclusion
The results are excellent if these tumors are cystic cerebellar astrocytoma and have been totally removed. Because only 5-20% of these lesions are histopathologically malignant.
