Gliomas are the most common type of primary brain tumor, originating from abnormal glial cells that support nerve cells. They can be slow-growing or aggressive, and the most common type of glioma is astrocytoma. Symptoms vary depending on the tumor's location and growth rate, but common signs include headaches, seizures, nausea, vision changes, and personality changes.

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Gliomas – Complete Details

Gliomas are a group of brain and spinal cord tumors that arise from glial cells, the supportive cells of the nervous system. They account for ~30% of all brain tumors and ~80% of malignant brain tumors.

1. What Are Glial Cells?

Gliomas originate from three main types of glial cells:

  • Astrocytes → Astrocytomas

  • Oligodendrocytes → Oligodendrogliomas

  • Ependymal cells → Ependymomas

These cells support, nourish, and protect neurons.

2. Types of Gliomas

A. Low-Grade Gliomas (Slow-growing)

  • Grade I: Pilocytic astrocytoma

  • Grade II: Diffuse astrocytoma, oligodendroglioma

B. High-Grade Gliomas (Fast-growing, aggressive)

  • Grade III: Anaplastic astrocytoma, anaplastic oligodendroglioma

  • Grade IV: Glioblastoma (GBM) — most aggressive form

3. WHO Classification (2021 update)

Modern classification uses molecular markers, not just microscopic features.

Key biomarkers:

  • IDH mutation status (IDH-mutant vs IDH-wildtype)

  • 1p/19q co-deletion

  • MGMT promoter methylation

  • TERT promoter mutation

These markers strongly affect diagnosis, prognosis, and treatment choice.

4. Symptoms of Gliomas

Symptoms depend on location, size, and growth rate:

  • Persistent headaches

  • Seizures

  • Weakness or paralysis

  • Speech difficulty

  • Vision or hearing problems

  • Balance issues

  • Personality/behavioral changes

  • Nausea/vomiting

  • Cognitive decline

5. Causes & Risk Factors

Most gliomas occur without a known cause. Known risk factors:

  • Ionizing radiation exposure

  • Genetic syndromes (rare):

    • Neurofibromatosis

    • Li-Fraumeni syndrome

    • Turcot syndrome

  • Family history (small increase in risk)

NOT linked to:

  • Mobile phone usage

  • Environmental toxins (with strong evidence)

6. Diagnosis

A. Imaging

  • MRI is the gold standard

  • MR spectroscopy, perfusion imaging, DWI help grade tumors

B. Biopsy

Needed to confirm:

  • Type

  • Grade

  • Molecular markers

C. Genetic Testing

Essential for treatment planning (IDH, 1p/19q, MGMT).

7. Treatment Options

Usually involves a combination of:

1. Surgery

  • Goal: Maximal safe resection

  • Reduces tumor load and symptoms

  • Provides tissue for diagnosis

2. Radiation Therapy

  • Used after surgery or when surgery is not possible

3. Chemotherapy

Common drugs:

  • Temozolomide (TMZ) — first-line, esp. for glioblastoma

  • Procarbazine, Lomustine, Vincristine (PCV regimen)

  • Bevacizumab (for recurrence)

4. Targeted / Molecular Therapy

  • IDH inhibitors (for IDH-mutant tumors)

  • Tumor-treating fields (TTF) for glioblastoma

5. Supportive Care

  • Anti-seizure medications

  • Steroids (to reduce swelling)

  • Rehabilitation therapies

8. Prognosis (Depends on type and grade)

Type Typical Survival
Grade I glioma Often curable
Grade II (low-grade) 7–15 years (if IDH-mutant)
Anaplastic Grade III 3–5 years
Glioblastoma (GBM, Grade IV) 12–18 months

IDH mutation improves prognosis significantly.
MGMT methylation improves response to temozolomide.

9. Key Points to Remember

  • Gliomas come from supporting brain cells (glia)

  • Classified by grade AND molecular markers

  • Treatment combines surgery + radiation + chemotherapy

  • Glioblastoma is the most aggressive form

  • Newer genetics-based treatments are improving outcomes

If you want, I can also provide:
✔ A short blog-style article in Tamil
✔ Treatment protocols
✔ Difference between glioma and glioblastoma
✔ Glioma symptoms explained by tumor location
✔ Notes for exam preparation

Just tell me!

 


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