Medulloblastoma is a neurological disease that occurs primarily in childhood. The malignant brain tumor occurs mainly in the back of the head, but has good chances of recovery. Research into the causes has not yet been adequately completed.
What is a medulloblastoma?
The medulloblastoma is considered to be the most common malignant brain tumor in children up to the age of 15. It develops as a malignant tumor in the area of the cerebellum, from where it usually grows to an adjacent brain chamber and then spreads to healthy tissue. See AbbreviationFinder for abbreviations related to Medulloblastoma.
The brainstem is also often affected by medulloblastoma. Metastases form primarily in the areas that are in contact with the cerebrospinal fluid. In addition to the ventricles themselves, this also includes areas around the brain, the meninges and the spinal cord.
On average, around 90 children develop a medulloblastoma each year. Boys are affected about one and a half times as often as girls. The age of the disease is usually between five and eight years.
Causes
The medulloblastoma usually develops spontaneously, which means that hereditary causes of the tumor are unlikely. However, the causes of the disease have not yet been adequately researched. However, it is known that the medulloblastoma degenerates from immature, embryonic cells, i.e. cells of the nerve tissue change malignantly.
In the case of diseases in adulthood, a connection between radiotherapy in childhood, for example in the course of the treatment of leukemia, and the development of the tumor in later life has repeatedly been established.
Symptoms, Ailments & Signs
A medulloblastoma increases in size quickly and causes the first symptoms relatively early. First, the tumor leads to increased pressure inside the skull. This results in a number of non-specific symptoms, such as headaches, nausea and vomiting or dizziness. Symptoms typically appear in the morning after getting up and diminish over the course of the day.
The nausea occurs mainly in the morning and on an empty stomach. Those affected also experience increasing malaise and a gradual deterioration in their physical and mental condition. For example, exhaustion, difficulty concentrating and sleeping problems occur. If the tumor is in the area behind the eyes, it can cause visual disturbances.
Then the patient perceives double vision, squints or suffers from eye tremors. A medulloblastoma also displaces the cerebellar structures. This causes movement disorders and other neurological disorders. Possible accompanying symptoms are numbness or tingling. In the worst case, paralysis occurs in the arms and legs.
As the tumor grows, the personality of the patient can change, and in the later stages of the disease they often appear irritable, restless, or confused. In addition, a hydrocephalus forms as a result of the outflow disorders of the cerebrospinal fluid. Other external signs can be tumors in the spinal cord canal and in the area of the skullcap.
Diagnosis & History
Numerous symptoms associated with a medulloblastoma are uncharacteristic, so they often also occur with other diseases and can have a harmless cause.
From headaches to nausea, dizziness and blurred vision to numbness, the list of symptoms is long. Coordination difficulties can also occur in the course of the disease. All symptoms that are triggered by the increasing pressure in the brain or caused by metastases, especially in the area of the spinal cord, are conceivable.
In particularly young patients, an increased increase in the head circumference and the so-called hydrocephalus can often be determined in the advanced stage.
The diagnosis is based on a detailed medical history. This is followed by the imaging procedures. The first examination results are obtained using computed tomography and magnetic resonance imaging. If there is reasonable suspicion of a medulloblastoma, a tissue sample is surgically taken and subjected to a histological examination.
A removal and examination of the spinal fluid is also necessary. Based on the examination results, the type of tumour, its location and size as well as its spread are diagnosed.
Complications
Because medulloblastoma is a tumor in the brain, it causes the usual symptoms of cancer. As a rule, in a very unfavorable case, the cancer can also spread to other regions of the body and also infect healthy tissue there. This reduces the life expectancy of those affected. For this reason, the further complications or chances of recovery depend very much on the time of diagnosis and the severity of the medulloblastoma.
Those affected primarily suffer from severe headaches and dizziness. There is also vomiting or squinting. Patients experience sensory disturbances or paralysis in various parts of the body. In many cases, there are also disturbances in coordination or concentration. Visual problems can also occur and thus significantly reduce the patient’s quality of life.
The treatment of medulloblastoma can be surgical and is not associated with complications. However, the patients are still dependent on chemotherapy, which can lead to various side effects. Further check-ups are also necessary after the treatment. Generally, it cannot be universally predicted whether medulloblastoma will lead to a reduction in life expectancy.
When should you go to the doctor?
Most cases of medulloblastoma occur in childhood. Therefore, adolescents are particularly affected by the disease and should be examined at the first sign. If the child complains of dizziness, headaches or difficulty sleeping, a doctor should be consulted. Impaired concentration, difficulty learning, or repeated vomiting are causes for concern. Strong symptoms at the beginning of the day are characteristic of medulloblastoma. In the next few hours, the intensity of the symptoms usually decreases. At the end of the day, there is often a feeling of recovery, until the following morning all the symptoms reappear.
Children who suffer from sudden visual impairments, unsteady gait and an increased risk of accidents and injuries must be presented to a doctor. A doctor is required in the case of sensory disorders of the skin, numbness or a tingling sensation on the skin. Movement disorders, a reduction in well-being and behavioral problems must be examined by a doctor. If the child shows unusual mood swings, if school performance decreases and if withdrawal behavior occurs, a doctor should be consulted. Lumps on the back along the spine, swelling or other changes in the appearance of the skin are signs of an existing disorder that require a doctor’s consultation.
Treatment & Therapy
The chances of treatment are favorable with early detection of the medulloblastoma . More than 70 percent of patients can already be cured today if the tumor is detected and treated in good time.
First, the tumor is removed as completely as possible. For this purpose, the skullcap is surgically opened and the diseased tissue is cut out. If possible, this is carried out using microsurgery or laser surgery in order to keep the subsequent physical symptoms as low as possible. In addition, therapy with radioactive radiation is carried out, since the tumor cells are particularly sensitive to radiation.
Alternatively, chemotherapy is given. Depending on the age of the patient and his development, possible side effects of both forms of therapy must be weighed up.
In the case of particularly large tumors or if the medulloblastoma is located in a very difficult-to-reach place, the diseased tissue can initially only be partially removed surgically and then reduced in size with radiation and chemotherapy. The remaining material can then be removed in a second surgical procedure.
In addition, it may be necessary to contain side effects. The outflow of the cerebrospinal fluid can be blocked or relocated by the medulloblastoma. This misalignment must then be remedied using a hose system. A so-called external drainage is often placed, with which the nerve fluid is drained to the outside.
Outlook & Forecast
The prognosis depends on the size of the tumor and the extent of tumor removal. In principle, the prospects are poor if metastases have formed. After surgery, about half of all patients are tumor-free. You can go on with a normal life. However, it cannot be ruled out that the tumor will recur. Therefore, aftercare is of great importance.
Medulloblastoma is more common in children compared to adults. A good one in five brain tumors in minors can be traced back to this disease; among adults it is only about one percent. 10 years after the start of treatment, 70 percent of all sick children are still alive. Children between the ages of four and nine and adults around the age of 30 are most frequently affected. The variants of the tumor have different expected values. The majority of all patients survive a desmoplastic medulloblastoma. Poorer healing prospects result from an anaplastic or large cell medulloblastoma.
Without treatment, patients risk the medulloblastoma growing and spreading further into the brain. Only consistent therapy can lead to freedom from symptoms. Life expectancy is significantly reduced without treatment.
Prevention
In principle, it is advisable to protect yourself and your children from the effects of radiation and pollution. Contact with carcinogenic chemicals should also be avoided. In addition, a healthy, balanced diet and sufficient exercise strengthen the immune system. Nevertheless, there are no general measures that prevent the development of a medulloblastoma.
Aftercare
As with all tumorous diseases, close follow-up care is required after treatment of the medulloblastoma. The aim of this is to detect any new tumors or metastases at a very early stage. In the case of a brain tumor, follow-up checks are therefore carried out several times a year at intervals of a few months.
If no abnormalities are found, the intervals between the next inspection increase. Whether there are any new growths is usually checked via MRI or CT. Precisely because malignant brain tumors often have a high risk of recurrence despite initially successful treatment, it is important that those affected attend their follow-up appointments regularly.
The prognosis for new tumors is more favorable the earlier they are discovered. New brain tumors do not always immediately lead to symptoms that should warn the patient. Findings that require treatment are often discovered by chance during follow-up care.
However, if unusual pain is noticed outside of the follow-up checks, this is always a reason to see the doctor treating you as soon as possible. He can decide whether the next follow-up appointment should be brought forward in order to be able to rule out the possibility of new tumors forming in a timely manner.
You can do that yourself
If a medulloblastoma has been diagnosed, surgical removal of the tumor is definitely indicated. The measures that those affected can take themselves depend on the severity of the tumor and any accompanying symptoms. In principle, the individual complaints can be treated by yourself.
Cool pads on the forehead and neck help against the typical headaches. Gentle natural remedies such as belladonna or arnica can also help. Nausea and vomiting can usually be relieved by eating a large meal. If serious symptoms such as blurred vision or balance problems occur, the doctor should be consulted. It is then best to refrain from self-treatment using home remedies.
After an operation, the person concerned should take it easy for a few weeks. At the same time, regular check-ups by the doctor are necessary in order to be able to identify any recurrences or other problems at an early stage. If physical symptoms develop as a result of the radiation treatment, medical advice is also required. General measures such as sport and a healthy and balanced diet help against typical after-effects such as tiredness and exhaustion. In addition to these measures, a therapist can be consulted to support the patient in dealing with the cancer.
