The cerebellum, located in the back of the skull immediately above the brain stem, is the second largest portion of the brain. It controls posture, equilibrium and balance as well as complex voluntary muscle movements such as walking and talking. Tumors within the cerebellum interfere with these functions, causing headaches, nausea and vomiting, or ataxia (difficulty coordinating muscle movements necessary to walk). Symptoms vary depending on the type, size and specific location of the tumor, and the speed at which it is growing.
Identification
Brain tumors, formed by groups of abnormal cells, can be benign (non-cancerous) or malignant (cancerous) within the cerebellum. Either type can develop within the cerebellum itself, or result from cancer spreading from other areas in the body. Regardless of the type or location of tumors, they need to be treated or removed.
Symptoms
Some cerebellum tumor symptoms are caused by an increase in intracranial pressure due to the space that the tumor occupies in the brain and the swelling that accompanies the existence of the tumor. These symptoms include headaches, nausea, dizziness, difficulty with coordination or balance, lethargy, confusion and disorientation.
Other symptoms are due to localized brain dysfunction caused by the tumor compressing or invading the surrounding brain cells. These types of symptoms include numbness or inability to control one or more limbs, vision loss, speech difficulty, impaired memory or judgment.
Patients who experience nausea and vomiting find that it is more prevalent upon waking in the morning. Headaches are also more severe in the morning. Specific symptoms vary with the location and size of the tumor within the cerebellum, and are used to pinpoint the tumor's location within the cerebellum.
Types
Tumors within the cerebellum are classified as either primary or secondary tumors. Primary tumors originate in the cerebellum, while secondary tumors spread from other parts of the body. Medulloblastomas are the most common type of primary brain tumor that develops within the cerebellum. These fast-growing tumors comprise 20 percent of brain tumors in children and adults. Cerebellar astrocytoma, the other primary type of tumor that affects the cerebellum, may be comprised of benign or malignant cells.
Secondary tumors occur when cancer metastasizes (spreads) from other parts of the body to the cerebellum. Skin, breast, colon, bowel, lung and kidney cancer can result in tumors within the cerebellum.
Diagnosis
Many symptoms experienced as a result of cerebellar tumors typically occur due to unrelated health concerns. If you are experiencing symptoms that cause concern, schedule an appointment with your health care provider. If your physician suspects a possible brain tumor, you will be referred to a neurologist, a specialist trained to diagnose and treat disorders that affect the brain, spinal cord and nervous system. After testing coordination, reflexes, hearing and vision that may be affected by a potential cerebellum tumor, you will be scheduled for additional tests if they are necessary for an accurate diagnosis.
Non-invasive tests such as an MRI (magnetic resonance imaging) and CAT scan (computerized tomography) provide detailed images of the brain. Other tests may be ordered to measure potential tumor activity and blood flow within the brain, such as PET scans (positron emission tomography), SPECT scans (single-photon emission computed tomography) or MRS scans (magnetic resonance spectroscopy).
The slightly more invasive angiogram, in which X-rays are taken after a special dye is injected, will help determine issues involving the arteries.
In some cases, a tumor biopsy, a surgical procedure during which a small sample of the tumor is removed and examined, may be necessary to determine an accurate diagnosis, prognosis and treatment.
Treatment
If the tumor can be safely removed from the cerebellum without injuring healthy cells, surgery is the recommended course of treatment. In those cases where the tumor can only be partially removed, or it will cause damage to attempt removal, radiation and chemotherapy are used to shrink the tumor.
High doses of radiation are directed at the head during radiation therapy to kill the abnormal cells. Chemotherapy is comprised of special medications that also kill the cancerous cells.
Ongoing clinical trials are dedicated to the discovery of new and improved courses of treatment to combat cerebellum tumors.
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