Anaplastic Astrocytoma

Anaplastic Astrocytoma – General Information

Anaplastic Astrocytoma – Symptoms

Some regional effects of the astrocytomas may include compression, destruction and invasion of the brain’s parenchyma. Competition for nutrients, venous and arterial hypoxia, metabolic end products release (for example free radicals, neurotransmitters, altered electrolytes), and recruitment and release of cell mediators (cytokines) may disrupt the usual parenchymal function. Powerful intracranial pressure (ICP) which is attributable to the direct effect of the mass, increased blood volume/cerebrospinal fluid (CSF) volume can mediate clinical sequelae which are secondary. Signs which are neurological and symptoms that can be attributed to astrocytomas may result from Central Nervous System functional perturbation. Neurological deficits which are focal (like weakness, sensory deficits, paralysis, cranial nerve palsies) and various characteristic seizures permit lesion localizations.

Infiltrating astrocytomas which are low-grade may grow slowly in comparison to their counterparts which are malignant. Dual time for low-grade astrocytomas can be estimated at four times the duration of Anaplastic Astrocytomas. A few years usually intervene between the first symptoms and the actual establishment of a certain diagnosis of the low-grade astrocytoma. In a recent series the interval was estimated to vary approximately from three to five years. This clinical course can be marked by gradual deterioration in half of the cases, a stepwise decline one third of the cases, and sudden deterioration in fifteen percent of cases. Seizures, which are often generalized, are initial symptoms that affect approximately one half of the patients with a case of low-grade astrocytoma. For the patients with Anaplastic Astrocytoma occurrence, the rate of growth and interval between symptoms’ onset and diagnosis definitely is intermediate between low-grade astrocytomas and glioblastomas.

Anaplastic Astrocytoma – Treatment

• Patients with an Anaplastic Astrocytoma and who have had seizures in the past should receive some anticonvulsant therapy and should have their drug concentrations in their blood stream closely monitored. A treatment with an anticonvulsant is used in patients with Anaplastic Astrocytoma that have had no seizures in the past has been reported, although this matter still remains controversial.

• Corticosteroids use, like dexamethasone, yields rapid improvement in many patients and also reduces the tumour’s mass effect. Concurrent prophylaxis used for gastrointestinal ulcers must be prescribed also with corticosteroid administration.

Surgical Care: The goals of surgery applied to the patient that has Anaplastic Astrocytoma are to remove the tumour and provide histological diagnosis tissue, that permits adjuvant therapy tailoring and prognosis assessment. A biopsy which is stereotactic is a safe and simple way for determining a tissue diagnosis. Stereotactic biopsy use may be limited by the sampling of the error and risking biopsy-induced intra-cerebral haemorrhage. The diversion of CSF by the ventricular drain which is external (EVD) or ventriculoperitoneal shunt (VPS) can be required to lower ICP as part of some non-operative management or maybe prior to final surgical therapy if the hydrocephalus occurs..

Total resection of Anaplastic Astrocytoma is usually impossible because the tumours usually invade eloquent brain regions and may exhibit tumour infiltration which can be only detected on microscopic scales. Thus, surgical resection may only provide for better survival advantage and complete diagnosis. However, craniotomy for tumour resection may be done safely and can be generally undertaken with the goal of causing least possible neural injuries to the person.
Consultations:

• To check to see if you are suffering from Anaplastic Astrocytoma, you should be consulted by a neurologist to document your detailed neurological exam. This makes a baseline and mostly assesses the probability of occult disease. This physician can also manage antiepileptic drugs for patients which manifest seizures.

• A doctor which is specialized in neurosurgery should be consulted for the assessment of the risks and benefits that surgical resection has to offer, stereotactic biopsy and radio surgery, and also CSF diversion.

• A doctor which is specialized in neuro-oncology can be consulted in the need of coordination of a comprehensive therapeutic plan. Once that a histological diagnosis is definitive, the doctor specialized in neuro-oncology can be consulted for providing comprehensive adjunctive therapy, that may include chemotherapy and radiation use.