Chamawonedwe glioma

Gliomas ndi zotupa zomwe zimamera m'malo osiyanasiyana amubongo. Optic gliomas angakhudze:

• Imodzi kapena iwiri yonse yamitsempha yamawonedwe yomwe imanyamula zidziwitso zowoneka kuubongo diso lililonse
• Chiwombankhanga chamawonedwe, malo omwe mitsempha yamawonedwe imadutsa patsogolo pa hypothalamus yaubongo

Optic glioma amathanso kukula limodzi ndi hypothalamic glioma.

Optic gliomas ndi osowa. Chifukwa cha optic gliomas sichidziwika. Ma optic gliomas ambiri amakula pang'onopang'ono ndipo samakhala ndi khansa (owopsa) ndipo amapezeka mwa ana, pafupifupi nthawi zonse asanakwanitse zaka 20. Matenda ambiri amapezeka ndi zaka 5.

Pali mgwirizano wamphamvu pakati pa optic glioma ndi mtundu wa neurofibromatosis 1 (NF1).

Zizindikiro zake zimabwera chifukwa chotupacho chimakula ndikukanikiza mitsempha yamawonedwe ndi nyumba zapafupi. Zizindikiro zimaphatikizapo:

• Kusuntha kwa diso la diso
• Kutupa kwakunja kwa diso limodzi kapena onse awiri
• Kuwombera
• Maso kutayika m'modzi kapena m'maso onse omwe amayamba ndikuwonongeka kwamaso ndipo pamapeto pake amatsogolera khungu

Mwanayo amatha kuwonetsa matenda a diencephalic syndrome, omwe akuphatikizapo:

• Kugona masana
• Kuchepetsa kukumbukira komanso kugwira ntchito kwa ubongo
• Kupweteka mutu
• Kukula kochedwa
• Kutaya mafuta m'thupi
• Kusanza

Kuyezetsa magazi ndi ubongo (neurologic) kumavumbula kutayika kwa m'maso kapena m'maso. Pakhoza kukhala kusintha kwamitsempha yamawonedwe, kuphatikiza kutupa kapena kufooka kwa mitsempha, kapena kupindika komanso kuwonongeka kwa disc ya optic.

Chotupacho chimatha kufikira mbali zakuya za ubongo. Pakhoza kukhala zizindikiro zakuchulukirachulukira muubongo (kupsinjika kwamkati). Pakhoza kukhala zizindikilo za neurofibromatosis mtundu 1 (NF1).

Mayesero otsatirawa akhoza kuchitidwa:

• Angiography ya ubongo
• Kuyesa kwa minofu yomwe idachotsedwa pachotupacho panthawi yochita opareshoni kapena kachipangizo kojambulidwa ndi CT kuti atsimikizire chotupacho
• Mutu CT scan kapena MRI yamutu
• Mayeso owoneka bwino

Chithandizo chimasiyanasiyana ndi kukula kwa chotupacho komanso thanzi la munthuyo. Cholinga chingakhale kuchiritsa vutoli, kuchepetsa zizindikiro, kapena kukonza masomphenya ndi kutonthoza.

Kuchita opaleshoni yotulutsa chotupacho kumatha kuchiritsa ma optic gliomas ena. Kuchotsa pang'ono kuti muchepetse kukula kwa chotupacho kumatha kuchitika nthawi zambiri. Izi zipangitsa kuti chotupacho chisawononge minofu yabwinobwino mozungulira. Chemotherapy itha kugwiritsidwa ntchito kwa ana ena. Chemotherapy itha kukhala yothandiza kwambiri ngati chotupacho chimafikira ku hypothalamus kapena ngati masomphenya awonjezeka chifukwa chakukula kwa chotupacho.

Thandizo la radiation lingalimbikitsidwe nthawi zina pamene chotupacho chikukula ngakhale chemotherapy, ndipo opaleshoni siyotheka. Nthawi zina, chithandizo cha radiation chikhoza kuchedwa chifukwa chotupacho chimakula pang'onopang'ono. Ana omwe ali ndi NF1 nthawi zambiri samalandira radiation chifukwa cha zotsatirapo zake.

Corticosteroids itha kulamulidwa kuti ichepetse kutupa ndi kutupa panthawi ya chithandizo chama radiation, kapena ngati zizindikiro zibwerera.

Mabungwe omwe amapereka chithandizo ndi zina zowonjezera ndi monga:

• Gulu la Oncology la Ana - www.childrensoncologygroup.org
• Neurofibromatosis Network - www.nfnetwork.org

Maganizo ake ndi osiyana kwambiri ndi munthu aliyense. Chithandizo cham'mbuyomu chimapangitsa kuti pakhale mwayi wabwino. Kutsata mosamala ndi gulu losamalira lomwe limakumana ndi chotupachi ndikofunikira.

Masomphenya atayika kuchokera pakukula kwa chotupa chamawonedwe, sangabwererenso.

Nthawi zambiri, chotupacho chimakula pang'onopang'ono, ndipo chimakhazikika nthawi yayitali. Komabe, chotupacho chitha kupitilirabe kukula, motero chimayenera kuyang'aniridwa mosamala.

Itanani yemwe amakuthandizani kuti musayang'ane masomphenya, kupweteka kwa diso, kapena zizindikilo zina za vutoli.

Upangiri wamtundu ungalandiridwe kwa anthu omwe ali ndi NF1. Kuyesedwa kwamaso pafupipafupi kumatha kupangitsa kuti azindikire ziphuphuzo zisanachitike.

Glitoma - chamawonedwe; Chamawonedwe mitsempha glioma; Achinyamata pilocytic astrocytoma; Khansa ya ubongo - optic glioma

• Neurofibromatosis I - ndikulitsa ma optic foramen

Eberhart CG. Adnexa wamaso ndi ocular. Mu: Goldblum JR, Nyali LW, McKenney JK, Myers JL, olemba. Rosai ndi Ackerman's Surgical Pathology. 11th ed. Philadelphia, PA: Elsevier; 2018: mutu 45.

Goodden J, Mallucci C. Optic njira yama hypothalamic gliomas. Mu: Winn HR, mkonzi. Opaleshoni ya Youmans ndi Winn Neurological. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2017: mutu 207.

Olitsky SE, Marsh JD. Zovuta zamitsempha yamawonedwe. Mu: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, olemba. Nelson Textbook of Pediatrics. Wolemba 21. Philadelphia, PA: Elsevier; 2020: chap 649.