Trình bày với suy chức năng tâm thần, đau đầu, co giật, hoặc các dấu hiệu thần kinh tiêu cự: Tăng áp lực nội sọ phát triển muộn glioblastoma đa dạng 20% của tất cả các khối u nội sọ, 55% của tất cả các u thần kinh đệm (astrocytoma biệt hoá), chủ yếu là não nhưng có thể ảnh hưởng đến tất cả các phần của não và tủy | CHAPTER 30 INTRACRANIAL NEOPLASMS 273 TABLE 30-2 Tumors Presenting with Impairment of Mental Function Headaches Seizures or Focal Neurologic Signs Increased Intracranial Pressure a Late Development Glioblastoma multiforme 20 of all intracranial tumors 55 of all anaplastic astrocytoma gliomas mainly cerebral but may affect all parts of brain and cord widely infiltrative survival about 12 months in most Astrocytomas low grade Oligodendroglioma Ependymoma Meningioma Primary cerebral lymphoma Metastatic carcinoma cases 25-30 of cerebral gliomas in adults common sites are cerebral hemispheres in children brainstem and cerebellum slowly growing tendency to form cysts survival for many years 5-7 of intracranial gliomas frontal lobes are most common sites slowly growing survival for many years if low-grade Common sites are fourth ventricle particularly in children conus medullaris and filum terminale survival depends on degree of anaplasia 15 of all primary intracranial tumors highest incidence in seventh decade more frequent in women common sites are sylvian region superior parasagittal surfaces olfactory groove lesser wing of sphenoid tuberculum sellae cerebellopontine angle spinal canal very slow growing symptoms depend on tumor site May arise in any part of the brain monofocal or multifocal often near lateral ventricle usually in adult life lymphocytes mononuclear and tumor cells often found in CSF immunosuppressed patients at risk particularly those with AIDS median survival less than 30 months Three main patterns 1 skull and dura from carcinoma of breast and prostate and multiple myeloma may compress spinal cord cranial nerves and pituitary 2 brain one or several cerebral or other foci from lung breast melanoma colon kidney 3 meningeal carcinomatosis or leukemic infiltration of leptomeninges and cranial and spinal nerve roots average survival 3 months with meningeal carcinomatosis patients with bony metastases survive longer 274 PART IV THE MAJOR CATEGORIES OF .
