Ependymoma is a tumor of the tissue of the central nervous system. In most cases, it is a benign tumor (grade I), but sometimes it can be malignant (cancerous) grade II or III and very serious. This disease can be located throughout the central nervous system, from the bottom of the brain (intracranial) to the spinal cord. Age plays a major role on the location where the tumor arises. For instance, in children the primary site is often intracranial (cerebral ependymoma), while it is spinal (Intramedullary ependymoma) in adults.
Cerebral Ependymoma – this type is when the tumor is in the brain. This form of Ependymoma tends to cause certain problems. The most restrictive (for surgery) is located at the intersection of the left and right ventricles (intraventricular), preventing the escape of cerebrospinal fluid and causing intracranial hypertension, high pressure of the cerebrospinal fluid (CSF) within the skull. Its removal may be accompanied by significant postoperative complications such as cerebral edema and coma. In the worst case, and depending on the location of ependymoma, the effects are accompanied by chronic epilepsy, aphasia (loss of speech) of recoverable as hemiplegia. In some cases, the amnesia is more or less extensive and causes severe depression with suicidal tendencies.
Intramedullary Ependymoma – When the tumor is in the bone narrow, it causes nerve compression. If it is in the cervical, these neurological disorders can affect the entire body, from sensitivity problems [tingling, stiffness of the joints (ankylosis), motor disorders, sphincter, and others] to total paralysis (quadriplegia). If it is at the level of the lumbar vertebrae (which is most often the case) the damage will be smaller but no less painful (muscle weakness of the legs up to paralysis (paraplegia), sensory disturbances, urinary pain radiating from the pelvis to the feet).
At the beginning the disease tends to make its presence felt by persistent headaches, balance, vision and memory problems. It may, at first glance, be confused with clinical depression (learn how to overcome depression safely) by some neurologists. Only a CT scan or MRI can detect the cause of these disorders and their original condition. In short, common ependymoma symptoms include:
- severe headache
- visual loss (due to papilledema)
- bilateral Babinski sign
- drowsiness (resulted from complications of the above symptoms).
Ependymoma treatment tends to include surgical procedures. But the operation is in any case extremely difficult and takes several hours. The surgical intervention is performed to remove the tumor without causing damage to nerve fibers often surround the tumor. In fact, even the best neurosurgeons often leave a small residual tumor to healthy tissue and thus avoid maximum postoperative neurological sequelae, pathological condition resulting from disease, injury, or other trauma such as surgery. Rare are the cases where surgery has helped to remove the entire tumor. Regardless, rehabilitation is usually necessary.
Additional treatment such as radiotherapy or chemotherapy may be considered. In all cases, an annual MRI is prescribed for life, to monitor the residual tumor. The headache can last for years, due to postoperative scar or trauma. In the most severe cases, the patient may need a second operation to establish aventricular valve to discharge the pressure of the cerebrospinal fluid into the vena cava.