Cerebellum tumors should be examined under two separate headings as adults and childhood. Approximately 70-75% of adult brain tumors settle in the brain.
60-70% of childhood brain tumors are seen 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 tumor in adults is glial tumors (astrocytomas), the most common cerebellum tumor is hemangioblastomas, whose genetic transition is well known.
The most common tumors after childhood leukemia are cerebellum tumors.
The most common ones 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 pontocerebellar corner region in adults (Schwannoma, meningioma, arachnoid and epidermoid cysts, plasmacytomas, glomus jugulare tumors, cerebellum metastases, etc.) (98003SERETELOMIC CYST) (9800370702) )
This cerebellum tumor constitutes on average 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 natural history. Certainly, these children have better outcomes than the other cerebellum tumors such as medulloblastoma, ependymomas, and lesions with brain stem glioma. When all of these tumors are removed, they have long-term survival rates. Cure is achieved in the treatment after a successful cerebrospinal surgery. Because only 5-20% of these lesions have histopathologically malignant features.
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 at the beginning. These leading complaints become persistent and persistent over time.
Complaints and Findings;
These children also primarily; personality changes, abnormal gait, double vision and changes in the level of consciousness are seen. Neck pain, slowing of heart rate (bradycardia), decrease in breathing frequency (bradypnea), complaints and signs of hypertension develop due to increased pressure in the brain stem. Confusion and closure always indicate a bad outcome. Eye examination reveals papilledema or sometimes optic atrophy. 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, reliable and harmless test method in the diagnosis of these lesions. In addition, the medicated brain Computed Tomography (CT) technique provides additional information compared to the MR technique in tumors such as some cerebellar tumors (eg ependymoma, cystic cerebellar astrocytomas). Cerebrovascular angiography test has no place in the diagnosis of these lesions. However, von-Hippel Lindou and cerebrovascular disease should be considered in those who are considered. With this test, the vascular relationships around the tumor are shown. 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, tumor marker tests from blood and cerebrospinal juice are not available for the diagnosis of cystic cerebellar astrocytomas in the cerebellum. Von-Hippel-lindau disease, especially with a cystic component, should be kept in mind in the differential diagnosis.
Treatment
As with all cerebellum tumors, if the doctor thinks that the cerebellum lesion is astrocytoma in the preoperative period, he should rule out von-Hippel Lindou disease in the differential diagnosis. In the treatment strategy of these lesions, first of all, the entire lesion should be surgically removed if possible. An experienced surgeon manages the operation 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 component are usually bloodless, soft lesions. If the histopathology is confirmed as low-grade atrocytoma after the entire tumor has been surgically removed, no additional adjuvant radiotherapy or chemotherapy is required for treatment. However, if the malignant type of histopathological astrocytoma is reported, additional radiotherapy and chemotherapy options 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.
