Cerebral Hemisphere Tumor
What is Cerebral Hemisphere Tumor
The cerebral hemispheres Is predilection sites of brain tumors, nerve on the degree of tissue-derived tumors, meningiomas, pituitary tumors, metastases incidence from high to low. Cerebral hemisphere tumors in children by the age of onset, more common primary neuroectodermal tumor, supratentorial ependymoma, astrocytoma, embryonic bad sex neuroectodermal tumors developers; adolescents more common ganglion glioma common in adults astrocytoma, glioblastoma multiforme, the meninges Cave, metastases, small sticks of glioma, primary hairy cell astrocytoma, pleomorphic yellow-shaped cell tumor, fibrosarcoma; central nervous system lymphoma.
Symptoms of Cerebral Hemisphere Tumor
The tumor clinical manifestations of cerebral hemisphere
(1) increased intracranial pressure, mainly headache, vomiting and papilledema three main symptoms.
(3) the focal symptoms of cerebral hemisphere tumors
1) frontal lobes: frontal lobe damage symptoms voluntary movement, three barriers of language expression and spiritual activities. Movement back to the central area, this area destructive lesions produce contralateral limb paralysis. Premotor area lesions caused by the spirit of the movement disorders, movement apraxia, less hyperactivity, exercise-induced sustained disease clonic tonic with strong grip, groping, sucking reflex. Island tegmental area of the primary side of the inferior frontal gyrus rear lesions produce motor aphasia. The amount of eye lesions to generate eyes gaze obstacles, destructive lesions produce eyes staring lesion side, irritating lesions appear eyes with partial to the opposite side or the other direction. Frontal gyrus lesion destruction of the amount of a bridge spinocerebellar tract, contralateral limb ataxia, nystagmus; bilateral lesions pseudobulbar palsy. In the forehead tumors mainly affect intelligence, attention and judgment. The frontal side of the rear of the paracentral lobule, where lesions produce incontinence, sensory disturbances and paralysis of the contralateral limb, as the most important to the foot. The sick side frontal bottom neoplasms can cause the loss of sense of smell, optic atrophy and papilledema (Foster-Kennedy syndrome) on the side. Prefrontal area known as the "dead zone" here tumor symptoms often not obvious.
2) parietal lobe: The main cause of central sensory disturbances. Postcentral gyrus by stimulation the contralateral sensorimotor epilepsy. Destructive lesions of cortical sensory dysfunction, manifested as skin positioning Jue skin writing Jue, the tip round distinguish Party, the weight feel entities sleep and two-point discrimination barriers. Deep sensory disturbances can cause sensory ataxia. The main hemisphere involvement appears Gerstmann syndrome, ie finger agnosia, miscalculation, the agraphia and around distinguish not. The primary side of the angular gyrus lesions can produce dyslexia. Body and space to identify barriers to non-primary side of the parietal lobe lesions can occur, such as not to admit of paralyzed limbs own or think to lose a limb, and can not be left in orientation.
3) Hao leaf: Hao lobe symptoms more like. Can produce temporal lobe epilepsy, visual hallucinations, visual field defects, the primary side of the hemisphere sensory aphasia. The Hao lobe epilepsy mainly psychomotor seizures, also known as the hippocampus uncus attack. More Magic Oh, Magic flavor aura was followed by a dream state, a sense of familiarity (deja vu levy, de ja vu), strange environment, familiar environment strangeness (like strangers levy, jamais vu). Visual hallucinations, auditory hallucinations, forced thinking or fear. Some patients suffer from mental disorders, such as repeated involuntary chewing, swallowing, licking tongue meals hanging around after you wake up on episodes nothing knowledge. The main lateral temporal gyrus involvement caused sensory aphasia, the auditory agnosia lost songs of disease. Deep temporal lobe optic radiation affected appear contralateral hemianopia quadrant hemianopia. Located Hao Ye ventrolateral tumors, therefore, at the session of the "dead zone" also can locate symptoms.
4) the occipital lobe: mainly for the visually impaired. Irritating lesions caused by the paroxysmal vision flash, white point, color and other visual hallucinations, or turned blind suddenly illuminated. The occipital visual hallucinations mental visual impairment, a visual distortion, spatial agnosia pretty material increase or recurring visual body obstacles, this temporal lobe lesions and visual hallucinations phase identification. Unilateral destructive lesions produce contralateral with hemianopia quadrant hemianopia; bilateral lesions can produce completely blind, or above or below the level of visual field defects, but the light reaction to exist. Cortical hemianopia involving the central macular area, known as macular evaded.
5) the insular cortex: where lesions mainly visceral nervous system symptoms. Clinical data suggest that as a representative of District of autonomic function.
6) basal ganglia: mainly reduce movement. Stiff facial expressions, eyelid retraction, limb rigidity and tremors, ataxia, the pediment gait and nystagmus. 20% of the leprosy epileptic absence seizures based. 25% of cases of dementia, memory loss. Tumor invasion and adjacent internal capsule with contralateral hemiplegia and hemisensory obstacles.
7) between brain: including the hypothalamus, the end of the thalamus, hypothalamus and surrounding structures of the third ventricle. Less the cerebral hemispheres tumor focal symptoms, there may be memory loss, unresponsive, dementia and lethargy. Range with the lesion, there may be a variety of sensory symptoms, such as hypoesthesia or paresthesia. Some patients had thalamic pain, performance contralateral diffuse pain, paroxysmal increase due to a variety of stimuli (De Jerine-Roussy syndrome). Tumors involving the internal capsule can cause a "partial" syndrome. Hypothalamic lesions autonomic nervous and endocrine dysfunction, such as diabetes insipidus. Fever, sexual dysfunction and sleep awakening exception.
8) The corpus callosum: cerebral hemisphere tumors with progressive dementia, apraxia, personality changes, and may be related to tumor invasion of the frontal lobe. Tumor in the middle of the corpus callosum in bilateral motor and sensory dysfunction, lower extremity weight in the upper limb, with the tumor to both sides of the violations of the movement, feeling related to the degree of quality. The corpus callosum rear tumors can be oppressive quadrigemina pineal region tumor symptoms. Cerebral aqueduct easily blocked, hydrocephalus and intracranial hypertension appeared earlier.
What Causes Cerebral Hemisphere Tumor
Tests and Diagnosis for Cerebral Hemisphere Tumor
Cerebral hemisphere tumor diagnostic tests
Diagnosis of tumors of the nervous system have significant value. Through different levels, different window level clear relationship between the tumor and surrounding structures. Visible in the CT level learning in: ① texture of the cerebral hemisphere tumors, such as cystic degeneration, hemorrhage, necrosis, calcification; ② surrounding brain tissue edema; ⑦ midline structures shift; ④ coronal CT of sellar tumors vector paraneoplastic falx tumor valuable; ⑤ bone window level CT visible bone changes of circumstances, enhanced CT, not only about the tumor's blood supply, and qualitative brain tumor greater value.
(2) MRI MRI examination of the brain and spinal cord is the most ideal, can provide a clear image of the anatomy, and can get more tissue section, coronal, sagittal, axial. After the application of paramagnetic contrast agents GdDTPA, help to improve the resolution and diagnostic rate. In recent years, in addition to get on MRI T1-weighted, proton-weighted, T2-weighted and enhanced MRI images, there are dynamic MRI, water suppression MRI Imaging (FLAIR), diffusion (Diffusion) MRI imaging, functional MRI, MRI vascular development (MRA MRV) and proton magnetic resonance spectroscopy (PMRS) and other new technologies. By MRI imaging technology, combined with the CT findings of a more definitive diagnosis and differential diagnosis of tumors of the central nervous system, but also a great help in guiding surgery.
The differential diagnosis of tumors of the cerebral hemisphere
1 astrocytic tumors (astrocytic tumor)
(1) diffuse astrocytoma (diffused astrocytoma)
WHO grade Ⅱ level, accounting for 10% to 15% of the tumors of the cerebral hemispheres, more common in adults 25 to 45 years old. Slow growth, longer course, an average of 1.5 to 3.5 years, the majority of the cerebral hemispheres cancer patients with a slow, progressive development. 50% of patients with epilepsy as the first symptom. CT common border less clear, uniform density of brain lesions, not enhanced. Mass effect is not obvious, bleeding lesions or necrosis within the tumor, the peritumoral edema shadow. Part of the tumor calcification, the cystic and enhanced. MRI tumor showed low signal (TlW) and high signal (T2W). MRI can clearly show the extent of the tumor-infiltrating brain tissue. This type of tumor is generally not enhanced, a few peripheral punctate mild enhancement film, often prompts the tumor progress.
(2) between the degeneration of astrocytes tumor (anapalastic astrocytoma)
Also known as malignant astrocytoma, the tumor cells of the cerebral hemisphere tumor malignant degree of astrocytoma and glioblastoma multiforme. WHO Ⅲ grade. Tumors occur in middle age (35 to 60 years old), men slightly more. Short duration, an average of 6 to 24 months. High intracranial pressure levy. Many psychiatric symptoms and focal neurological disorders such as limb weakness, speech difficulties, vision change and lethargy. Rare seizures. CT showed a low density or uneven low-density and high-density mixed lesions. Mass effect is obvious. Associated with peritumoral edema, 20% of cystic degeneration, calcification 10%. Low signal MRI tumor T1W, T2W high signal more The pleomorphic glioblastoma image slightly uniform, no necrosis or hemorrhage. 80% to 90% of tumor enhancement, is annular, nodular-shaped, irregular shaped, etc., and another part of the brain hemisphere tumor to enhance uniform.
(3) glioblastomas (glioblastoma), also known as glioblastoma multiforme (GBM), the most malignant glioma astrocytomas neuroectodermal tumors of origin 50% to 55 %. WHO Ⅳ grade. The predilection to 45 to 65-year-old male predominance. Short duration (3 to 6 months half). Obvious sign of high intracranial pressure. Focal neurological disorders. CT showed low, and other mixed-density shadow, high density hemorrhage area surrounding brain tissue showed large areas of low-density edema. Tumor and brain tissue boundary. 95% of the enhanced tumor showed heterogeneous enhancement, irregular ring usually presents with central necrosis or cystic areas of low density, peripheral proliferative vascular area, the island-shaped or spiral strengthen shadow. MRI showed low signal in TlW, T2W high signal ill-tumor shadow. But in the tumor cells proliferation, TlW the high signal, T2W low signal. Enhanced to strengthen the performance of the same CT. Radionuclide imaging showed that the tumor cell proliferation at the concentration of radioactive nuclides.
(4) gliosarcoma (gliosarcoma)
The gliosarcoma addition to the characteristics of glioblastoma multiforme yet sarcoma characteristics. WHO Ⅳ grade. The course of the disease after tumors like glioblastoma and clinical symptoms. Turn predilection hao, frontal, parietal, and occipital lobes. Some patients with liver, lung and other distant metastases. CT and MRI to enhance substantive placeholder shadow, edema. Tumors located on the surface of the brain, often the external carotid artery, blood supply, angiography common the deeper tumor stained with meningioma similar and difficult to distinguish.
(5) pilocytic astrocytoma (pilocytic astrccytoma)
WHO Ⅰ. Longer course. Occurs in children and adolescents. The type of tumor of the brain seizures, symptoms of increased intracranial pressure and focal symptoms. Depending on road type tumors mainly for the visually impaired. Can hypothalamic symptoms. Imaging astrocytoma brain-type hair cells often clear boundary, mostly cystic tumors mural nodules sometimes strengthen. Essilor type tumors substantive strengthen significantly enhanced uniform.
(6) pleomorphic yellow astrocytoma (pleomorphic xanthoastrocytoma, PXA) WHO Ⅱ level. Rare, less than 1% of astrocytomas. Located in the surface of the cerebral hemispheres, the temporal lobe is the most common. Predilection for youth. Longer course, with an average of 6.2 to 7.6 years. About 70% of the seizures, followed by focal cerebral hemispheres symptoms and intracranial hypertension levy. CT and MRI were seen in the cerebral hemispheres superficial, irregular the placeholder shadow, peritumoral edema. Tumor density on CT and MRI or signal uneven, sometimes cystic. A substantial part of the enhanced tumor can be strengthened.
(7) a small branch limb stromal tumors (oligodengroglioma)
About 4% of intracranial gliomas, mostly in the white matter of the cerebral hemispheres. WHO Ⅱ level. Longer course, an average of four years. The adult common, occur in the 38 to 45 years old. The first symptom of epilepsy. May have focal symptoms of high intracranial pressure levy. CT high density calcification in 90% of tumors, often in the tumor periphery Ministry. The noncalcified performance is low density, can be enhanced to strengthen. Tumor T1W low signal on MRI, T2W high signal calcification signal Absence peritumoral brain edema is not obvious.
(8) ganglia glioma (ganglioglioma)
Rare, accounting for 0.4% of the brain tumor originated in the undifferentiated cells eventually differentiate into mature neurons and glial cells. WHO Ⅱ level. Occurs in children and young people. Longer course, an average of 1.5 to 4.8 years. Epilepsy more common, regular antiepileptic medication often can not control. Focal symptoms are rare. The CT manifestations diversity. Most of the low-density or density, a small number of high density. Tumor border clearance calcification or cystic each about 1/3. Part can be strengthened. Tumor mass effect of brain tissue the obvious edema rare. The T1W dry low signal on MRI, T2W hyperintense the border clear placeholder shadow of, lesions around the brain back to have swelling.
(9) embryonic dysplastic neuroepithelial tumor (dysembryoplastie neuroepithelial tumour, DNT)
DNT rare, mainly seen in children and young patients. DNT embryonic dysplasia and tumor formation, so that the tumor from a variety of nerve cells associated with cortical dysplasia. DNT longer course, but often the onset in childhood or young man. Mainly for complex focal epileptic seizures. Epilepsy often stubborn and difficult to control. Sometimes the lesion side with skull deformation. CT hypodense mass effect is not obvious, sometimes visible calcification. MRI showed a low signal, T2W showed high signal in T1W. Peritumoral edema. Enhanced tumor enhancement.
(10) primitive neuroectodermal tumor (primitive neuroeetodermal tumor, PNET) malignancy, WHO Ⅳ level. Occurs in children, accounting for 2.5% of children with brain tumors, no significant gender differences. The tumor is located in the cerebral hemispheres common. With medulloblastoma tumor histology on basically the same. Children with shorter clinical course, mainly headache, nausea, vomiting, seizures, blurred vision, and symptoms of the same stove parts. Tumor on CT and MRI imaging performance in medulloblastoma similar, but common peritumoral edema. The cranial MRI hinge easily found disseminated tumor along the cerebrospinal fluid, nearly half of patients with metastases.
(1) neuroblastoma (neurobastoma)
The intracranial primary neuroblastoma is very rare, mainly in pediatric patients. Short duration. Epilepsy, focal neurological symptoms and symptoms of intracranial hypertension as the main performance. Common metastases. CT can be as low density, such as density or high density, peritumoral edema and intratumoral calcification is common. Low signal on MRI TlW, T2W high signal. Enhanced tumor strengthening obvious part of the tumor with cystic degeneration. MRI found tumors in intracranial and spinal metastases.
(12) glioma disease (gliomatosis cerebri.GC)
Also known as diffuse glioma disease, lesions involving the scope of the whole brain anaplastic astrocytoma diffuse proliferation characterized. GC short course a few weeks, a few up to 10 to 20 years, the elderly. Clinically non-specific pieces, the first symptom is a common headache and epilepsy. In addition, abnormal behavior, personality changes associated with early manifestation of the disease. After intracranial hypertension with multiple sites of focal symptoms often sexual development, hemiplegia, ataxia the hemisensory disorder, speech disorder, diplopia, blurred vision. MRI was brain diffuse or multiple abnormal signal, involvement at the blurring of gray and white matter. T1W images showed low signal. Diffuse high signal TZW image has diagnostic value.
2 meningiomas (meningioma)
After the incidence of glioma, accounting for 15% to 24% of intracranial tumors. Can be seen at any age, but the middle-aged predilection. Female to male ratio of 3:2. Slow tumor growth, longer course. Most tumors grow very large, very mild symptoms. More than irritating symptoms (such as epilepsy) first became paralytic symptoms (such as paralysis). Increased intracranial pressure symptoms and focal neurological dysfunction. The CT manifestations: (1) tumors were round or lobulated or flat, clear boundaries; ② Most lesions showed uniform density or high density, few can be uneven or cystic change; ③ intratumoral calcification and more uniform, but can be irregular ; ④ partial skull hyperplasia or broken ring; enhanced low density with or edema of the ⑤ half of the patients in the vicinity of the tumor. MRI findings: ① most lesions T1W low signal T2W high signal; ② enhanced after scanning homogeneous enhancement. Dural tail sign; ③ tumor and adjacent brain tissue between the a low signal arachnoid interface; ④ T2W peritumoral edema; ⑤ clearly show the relationship between the tumor and the blood vessels, sinusoids. Digital subtraction angiography (DSA) examination showed: ① The tumor main blood supply from the external carotid artery system; ② the capillaries period see a more mature tumor staining; ③ venous phase see thick draining veins surrounding the tumor.
3 hemangiopericytoma (hemangiopeticytomas)
Rare vascular tumor, is the most common non-meningeal stromal tumors of epithelial origin. Duration of more than 1 year, good hair in 40 to 45 years old, male predominance. The signs and symptoms depend on the site of the lesions and volume. CT and MRI manifestations similar meningioma, not easy to distinguish between the two. Hemangiopericytoma blood for richer, no tumor calcification, intratumoral calcification can be excluded.
Metastatic tumors (metastases).
12% to 21% of the total cerebral hemisphere tumors. Lung cancer is the most common male, female breast cancer by the majority. The clinical manifestations much like the brain primary tumors, but the following conditions should be suspected as metastases: ① systematic history of cancer, but a few can be no; (2) age greater than 40 years old, with a history of smoking; (3) symptomatic epilepsy associated with weight loss or the rapid development of limb weakness. CT shows solitary or multiple, low-density or density lesions, often isolated class round, smaller, and edema of the surrounding brain tissue. Enhanced common boundary clear ring enhancement, homogeneous or heterogeneous enhancement stove. MRI see around metastases edema T1W low signal area, T2W high signal area, hemorrhage or cystic signal changing. The chest radiograph See helpful in the diagnosis of tumor, but negative still can not be ruled out.
5 primary central nervous system lymphoma (primary CNS lymphoma)
0.5% to 1.5% of the total cerebral hemisphere tumors. AIDS (AIDS) patients, a slightly higher proportion of about 1.9% to 6%. The average duration of 2 months. Occur in the 50 to 60-year-old, male predominance. AIDS patients younger age at onset, the average 35-year-old. Increased intracranial pressure and local nerve dysfunction as the main performance. CT scan showed slightly higher density, strengthen uniform evident. MRI T1W and T2W are low signal to strengthen significantly, such as cotton-like, around more with cerebral edema. Within the lesion was high generation shot this with infarction, infection focus or demyelination identify computer X-ray tomography (PET).
6 melanocytes disease (melanocytic lesions)
The melanoma cell disease of the central nervous system diffuse or localized benign and malignant tumors originated in leptomeningeal melanocytes. This group of tumors, including the melanin cancer diffuse (diffuse melanosis), melanoma (melanocytoma) and malignant melanoma (malignant melanoma). Melanoma accounts for 0.06% to 0.1% of intracranial tumors, and even fewer of the other two types of tumor. Clinical course of the disease is short. The increased intracranial Asia and neurological symptoms of weeks stove. Often associated with subarachnoid hemorrhage or tumor hemorrhage. Mi the steamed bread melanin fibromatosis common epilepsy, psychiatric symptoms, a few symptoms. The high signal prompted in the MRI TlW on melanin deposition. Diffuse melanin fibromatosis performance diffuse leptomeningeal thickening and enhancement on CT and MRI; melanoma. MRI TlW or high signal, T2W signal was low, lesion uniform enhancement; malignant melanoma, according to the extent of intratumoral hemorrhage, MRI signal changing.
Treatments of Cerebral Hemisphere Tumor
The treatment of tumors of the cerebral hemisphere
1. Surgical treatment of tumors of the brain hemispheres
Is one of the most basic treatment of tumors of the brain hemisphere. The purpose of surgery is to remove the tumor and reduce intracranial pressure and to confirm the diagnosis. Where the tumor growth in the parts that can be removed by surgery, should be considered first surgery. Disturbance of consciousness, brain herniation symptoms of cases, cerebral hemisphere tumor surgery as an emergency measure. The surgery should total resection of the tumor as possible. The tumor was totally removed prognosis was significantly better than the part or subtotal resection of the tumor. Resection of the tumor was not caused by a serious invalidity or increased postoperative complications and mortality. Deep parts or invading tumor of important neural structures can be partial tumor resection and decompression, decompression craniectomy, cerebrospinal fluid drainage or shunt to relieve intracranial pressure, and for radiation therapy , chemotherapy and other medical treatments and other measures to create conditions. The important part for brain tumor biopsy is the surgical treatment of intracranial multiple lesions suspected germ cell tumors is particularly suitable in the hypothalamus. Biopsy can confirm the diagnosis, to avoid the serious consequences caused by the blind surgery can correct the non-surgical treatment options for patients to develop.
Radiation therapy of cerebral hemisphere tumors
The treatment of tumors of the brain hemispheres is an important complement to the current including conventional radiology live spa radiotherapy, stereotactic radiosurgery and radionuclides. Conventional radiotherapy commonly used linear accelerator and 60Co therapy machine, radioactive-sensitive tumors. Stereotactic radiosurgery cure mainly represented by γ-knife. Suitable for tumors less than 3 cm in diameter, certainly better than. X-knife stereotactic radiotherapy for another, to be applied to the larger diameter of the tumor, but the overall effect is not as good as γ knife. Radionuclide radiation therapy for the cystic craniopharyngioma Camp tumor. Invasive pituitary adenoma and intracranial tumors, commonly used radionuclides 32P, 198Au with 90Y. Whole brain - spinal cord irradiation, the need for easy spread of the tumor in the subarachnoid space. Low-grade astrocytomas postoperative radiotherapy are still disputing that postoperative CT or MRI confirmed total tumor removal can be temporarily radiotherapy. Residual postoperative radiation therapy should line but confirmed that postoperative radiation therapy to improve the survival rate of the patients with postoperative residual low-grade astrocytomas. Cerebral hemisphere tumor residual postoperative radiotherapy 5-year survival was only 19%, while the radiation by up to 46%. Residual cerebral hemisphere tumor surgery less than 2 cm in diameter, meningiomas, pituitary tumors, nerve sheath tumor, gamma-knife treatment available to good effect. Tumors of the central nervous system radiation dose should be large enough, it generally takes to reach 55 to 60 Gy. However, radiation therapy is prone to radiation injury of the central nervous Sounds. In children less than 2 years of age due to the central nervous system is not yet fully developed, radiation therapy should be delayed to 3 years of age. Radiation damage caused by the radioactive radiation dose was positively correlated, and most irreversible lesions. Therefore, its must be emphasized prevention: (1) is not excessive radiation; ② avoid repeated irradiation; the ③ enough sleep, rest and adequate nutrition; ④ of hormone and vitamins. Common radiation injury delayed radiation necrosis, hypopituitarism, optic nerve damage, blindness, brain stem radiation injury and nuclear cranial nerve palsy, spinal cord injury, radiation-induced tumors and late smart decline. Therefore, in the design of radiotherapy plan, should be weighed against the important structure do the appropriate protection.
Cerebral hemisphere tumor chemotherapy
Chemical treatment of brain tumors must be established on the basis of brain tumor surgical resection. Cerebral hemisphere tumor residual tumor after the less, the more significant effect of chemotherapy, chemotherapy is therefore a necessary complement of malignant brain tumor surgery cure. Variety of chemotherapy drugs in combination can enhance the drug sensitivity of the tumor to reduce the tolerability and reduced toxicity. Thereby enhancing efficacy. Should pay attention to the order of administration of chemotherapy drugs in the combination of chemotherapy drugs, and different chemotherapy drugs have different modes of administration. There are several commonly used chemotherapy drugs.
A smaller relative molecular mass, the highly lipophilic CCNS class alkylating agents, and more easily through the blood-brain barrier, including the diclofenac ethylmethylene denitrification urea (BCNU), lomustine (CCNU) Secretary Secretary Mo Ting (MeCCNU), Nimustine (ACNU). Many of the central nervous system tumors were killing effect.
(2) procarbazine (PCB)
Was soluble, a monoamine oxidase inhibitor, but its anti-tumor effect of its metabolic having alkylating activity of AGEs. After gastrointestinal absorption, plasma clearance is more rapid, and easy to enter the blood-brain barrier. Plasma levels in cerebrospinal fluid drug concentration can be achieved within a few minutes after intravenous injection. Oral daily dose of 150 mg/m2, for taking two weeks. The main side effects are nausea, loss of appetite, and mild to moderate bone marrow suppression.
Symptomatic treatment of cerebral hemisphere tumors
Reduce intracranial pressure in tumors before and after treatment, to control seizures ashamed and treatment. Dehydrating agent currently used 20% mannitol, 10% glycerol, fructose, furosemide, 20% (or 25%) of human serum albumin and the like. Cancer patients, mannitol or glycerol fructose hormones (such as dexamethasone) can make a buck ashamed strengthen. Seizures in patients with anti-epileptic drugs, regular blood concentration determination of anti-epileptic drugs, and pay attention to the side effects. Sellar tumor patients with low hormone levels hormone replacement therapy should be used, optional prednisone, methylprednisolone, dexamethasone, hydrocortisone, cortisone acetate treatment. The brain hemisphere tumor resection doubt may vasospasm patients, should be the early use of vasodilators, such as nimodipine.