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Glioma diagnosis

Gliomas are diagnosed based on their age, gender, location of occurrence, and clinical process, and their pathological type is estimated. In addition to medical history and neurological examination, some auxiliary examinations are also needed to assist in diagnosis, localization, and qualitative analysis.

1. Cerebrospinal fluid examination

The pressure during lumbar puncture is mostly increased. Some tumors, such as those located on the surface of the brain or in the ventricles, may have an increase in cerebrospinal fluid protein levels and white blood cell counts, while others may show tumor cells. But for those with significantly increased intracranial pressure, lumbar puncture poses a risk of promoting cerebral herniation. Therefore, it is generally only done when necessary, if it needs to be distinguished from inflammation or bleeding. Individuals with significant increase in pressure should be handled with caution and avoid excessive discharge of cerebrospinal fluid. Administer mannitol drip after surgery and observe carefully.

2. Ultrasonic examination

Can assist in lateralization and observe the presence of hydrocephalus. Infants can undergo B-mode ultrasound scanning through the anterior fontanelle, which can display tumor images and other pathological changes.

3. EEG examination

The changes in electroencephalogram (EEG) of gliomas are limited to changes in brain waves at the tumor site. On the other hand, there are generally widely distributed changes in frequency and amplitude. These are influenced by tumor size, invasiveness, degree of brain edema, and increased intracranial pressure. Shallow tumors are prone to localized abnormalities, while deep tumors have fewer localized changes. In benign astrocytomas, oligodendrogliomas, and other conditions, the main manifestation is localization δ Epilepsy waveforms such as spike waves or sharp waves can be seen in some cases. Large pleomorphic glioblastoma can manifest as extensive δ Wave, sometimes can only be fixed on one side.

4. Radioisotope scanning (Y-ray brain image)

Tumors with fast growth and abundant blood supply have high blood-brain barrier permeability and high isotope absorption rate. If pleomorphic glioblastoma shows isotopic enrichment imaging, there may be a low-density area due to necrosis and cyst formation in the middle, which needs to be differentiated from metastatic tumors based on its shape, multiple nature, etc. Benign gliomas such as astrocytomas have lower concentrations and are often slightly higher than the surrounding brain tissue, with unclear imaging and some may be negative findings.

5. Radiological examination

Including cranial plain film, ventriculography, electronic computed tomography, etc. Head plain film can display signs of increased intracranial pressure, tumor calcification, and pineal gland calcification displacement. Ventricular angiography can display the displacement of cerebral blood vessels and the condition of tumor blood vessels. These abnormal changes vary in different parts and types of tumors, and can assist in localization, sometimes even qualitative analysis. Especially CT scanning has great diagnostic value, with intravenous contrast enhanced scanning achieving almost 100% accuracy in localization and over 90% accuracy in qualitative diagnosis. It can display the location, range, shape, brain tissue response, and ventricular compression displacement of the tumor. However, it is still necessary to consider clinical factors comprehensively in order to make a clear diagnosis.

6. Nuclear magnetic resonance

The diagnosis of brain tumors is more accurate and the imaging is clearer than CT, which can detect small tumors that CT cannot display.

Electron emission tomography can obtain images similar to CT and observe the growth and metabolism of tumors, distinguishing between benign and malignant tumors.

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