脑转移瘤

概述

当癌细胞从原发部位扩散到脑时，就会发生脑转移。任何癌症都可能扩散到脑。但最常见的传播类型是肺、乳腺、结肠、肾脏和黑色素瘤。

脑转移可在脑内形成一个或多个肿瘤。随着它们的生长，它们会对周围的脑组织造成压力。这可能会导致头痛、人格改变、意识模糊、癫痫发作、视力改变、说话困难、麻木感、无力或失衡等症状。

对于癌症扩散到脑的患者，治疗可能包括手术、放射疗法、免疫疗法、靶向治疗或化疗。可能采用其他治疗来减轻癌症引起的疼痛和症状。

Types

Brain metastases, also called brain mets or secondary brain tumors, occur when cancer spreads from another part of the body to the brain.

Brain metastases are classified based on where cancer cells spread within the central nervous system. The two main patterns of spread are parenchymal metastases and leptomeningeal metastases. These patterns affect different parts of the brain and spinal cord and may require different approaches to diagnosis and treatment.

Parenchymal metastases

Parenchymal metastases occur when cancer spreads from another part of the body into the brain tissue itself. These form discrete tumors within the brain. A person may have one tumor or several tumors located in different areas.

Parenchymal metastases are the most common form of brain metastasis.

Leptomeningeal metastases, also called leptomeningeal disease

Leptomeningeal metastases, also called leptomeningeal disease (LMD) or neoplastic meningitis, occur when cancer cells spread to the thin layers of tissue and the cerebrospinal fluid that surround the brain and spinal cord.

Instead of forming a single mass, cancer cells spread along the surface of the brain and spinal cord and within the fluid that circulates around them. This pattern of spread can affect multiple areas of the nervous system.

症状

脑转移引起的症状可能有所不同。它们取决于位置、大小和增长速度。

脑转移的症状包括：

• 头痛，有时伴有呕吐或恶心。
• 精神变化，例如记忆力问题渐增。
• 癫痫发作。
• 身体一侧无力或麻木感。
• 视力改变。
• 说话困难或理解语言困难。
• 失衡。

Symptoms of parenchymal metastases

Parenchymal metastases form tumors within the brain tissue. Symptoms usually relate to the specific area of the brain where the tumor is located.

Symptoms may include:

• Headache, which may become more frequent or more severe over time and may occur with nausea or vomiting.
• Changes in thinking or behavior, such as confusion, difficulty concentrating or increasing memory issues.
• Seizures, even in people who have never had seizures before.
• Weakness or numbness, often affecting one side of the body.
• Vision changes, such as blurred vision, double vision or loss of part of the visual field.
• Difficulty speaking or understanding language.
• Balance or coordination issues.

Symptoms of leptomeningeal metastases

Leptomeningeal metastases involve cancer cells spreading within the fluid and thin tissues that surround the brain and spinal cord. Because this spread can affect multiple areas of the nervous system at the same time, symptoms may be more widespread.

Symptoms may include:

• Headaches.
• Nausea and vomiting.
• Vision changes, such as blurred vision or double vision.
• Facial weakness or numbness.
• Hearing loss.
• Difficulty swallowing.
• Confusion or changes in thinking or behavior.
• Weakness or loss of feeling in the arms or legs.
• Back or neck pain that may spread into the arms or legs.
• Difficulty with bowel or bladder control.
• Changes in alertness.
• Seizures.

何时就诊

如果出现令您担心的持续体征或症状，请与医疗护理专业人员约诊。如果您曾经接受过癌症治疗，请将您的病史告知医生。

病因

当癌细胞从原发位置扩散时，就会引起脑转移。细胞可能通过血流或淋巴系统转移并扩散到脑部。

从原发位置扩散的癌症根据原发性癌症命名。例如，从乳房扩散到脑部的癌症称为转移性乳腺癌，而不是脑癌。

风险因素

任何类型的癌症都可能扩散到脑。一些更有可能扩散的类型包括：

• 肺癌。
• 乳腺癌。
• 结肠癌。
• 肾癌。
• 黑色素瘤。

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