小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
其他诊断因素
- 意识状态改变
- 头痛
- 恶心和/或呕吐
- 步态异常
- 共济失调
- 虚弱
- 惊厥
- 视觉障碍
- 语言功能缺失
- 失语症/言语障碍症
- 感觉缺失
- 运动无力
- 视觉改变
- 颅神经麻痹
- 视神经乳头水肿
- 人格改变/情绪不稳
危险因素
- 白人血统
- 男性
- 神经纤维瘤病 1 型
- 复合型结节性硬化病
- Li-Fraumeni 综合征
- 胶质瘤息肉病综合征
- 电离辐射
诊断性检查
首要检查
- 头部 MRI
- 眼科评估:视野检查
- 头颅 CT
- 脑 MR 波谱
- 脑灌注 MRI
- 组织病理学
- 分子分析
需考虑的检查
- 垂体激素检测
- 弥散张量成像(DTI)
新兴检查
- 2-羟基戊二酸-靶向磁共振波谱
治疗流程
颅内压升高或血管源性脑水肿
局限性胶质瘤:毛细胞型/毛细胞黏液样星形细胞瘤
局限性胶质瘤:室管膜下巨细胞型星形细胞瘤(SEGA)
局限性胶质瘤:多形性黄色瘤型星形细胞瘤
弥漫性浸润胶质瘤:2 级
弥漫性浸润胶质瘤:3 级和 4 级
H3 K27 变异型弥漫性中线胶质瘤
复发性局限性胶质瘤
进行性弥漫性浸润胶质瘤
撰稿人
作者
L. Nicolas Gonzalez Castro, MD, PhD
Instructor in Neurology
Center for Neuro-Oncology
Dana-Farber Cancer Institute and Brigham and Women's Hospital
Harvard Medical School
Boston
MA
利益声明
LNGC has received research funding from the National Institutes of Health, the Robert Wood Johnson Foundation, the American Society of Clinical Oncology, and Merck & Co. (to Dana-Farber Cancer Institute), and acted as consultant for Teladoc, Elsevier PracticeUpdate, and Oakstone Publishing. LNGC is an author of a number of references cited in this topic.
鸣谢
Dr L. Nicolas Gonzalez Castro would like to gratefully acknowledge Dr Timothy C. Ryken, Dr Linton T. Evans, Dr Manmeet S. Ahluwalia, Dr Susan Chang, and Dr Karine Michaud, previous contributors to this topic.
利益声明
TCR is an author of a number of references cited in this topic. MSA has acted as a consultant for Elekta, Incyte, AstraZeneca, Novocure, Caris Life Sciences, Bristol-Myers Squibb, Monteris Medical, AbbVie, MRI Solutions, Elsevier, and Prime oncology. MSA has received clinical trial investigations grants from Tracon, Bristol-Myers Squibb, AstraZeneca, Novartis, and Novocure. SC has received research support from Agios, Novartis, Quest, Roche, and Schering Plough. KM and LTE declare that they have no competing interests.
同行评议者
David A. Reardon, MD
Associate Professor
The Preston Robert Tisch Brain Tumor Center
Duke University Medical Center
Durham
NC
利益声明
DAR declares that he has no competing interests.
鉴别诊断
- 脑转移瘤
- 脑脓肿
- 多发性硬化
更多 鉴别诊断指南
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- 成人弥漫性星形细胞和少突胶质细胞肿瘤疗法:ASCO-SNO 指南
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