Monday, February 2, 2015

Tumors of the Hypothalamus or Brainstem

One of the trademark symptoms of Neurofibromatosis is tumor growth on the ends of nerves. Previously I have discussed optic nerve tumors that commonly grow on the optic nerves of children, and different types of fibromas, but I haven't yet discussed tumors that grow in the hypothalamus and pituitary region of the brain as well as on the brainstem.... so here is some information on these types of tumors:

1. Tumors of the Hypothalamus and Pituitary Region

The pituitary gland is commonly known as the "master gland", because it controls the function and regulation of other hormone producing body parts (such as the thyroid gland and ovaries). There are two different things that can happen when a tumor grows on or near the pituitary gland:

a) There can be an under production of hormones -- this can cause many different things, such as delayed puberty, short stature, weight gain,anemia, infertility, depression....

b) There can be an over production of hormones -- this can also cause a variety of different symptoms such as gigantism (being very tall, usually more than 7.5 feet), heart enlargement, heart failure, osteoperosis, arthritis

The release of hormones by the pituitary gland is controlled by the hypothalamus. The hypothalamus is responsible for "monitoring and regulating the body's functions". The hypothalamus also controls the regulation of hormones that trigger puberty, and if there is a brain tumor in this region it can cause a child to enter puberty at an early age (under the age of 7 for girls and under the age of 8 for boys). Not only can tumors of the hypothalamus cause early onset of puberty, but it can also cause late onset puberty which is characterized by children who haven't entered puberty by the age of 15.

Treatment for these kinds of tumors depends on the exact location of the tumor as well as how aggressive it is. Typically surgery is not an option to remove these tumors, as there is a high risk of damaging too much brain tissue in order to remove the tumor. Instead. radiation and chemotherapy are used to reduce the size of the tumor, Research has actually shown that radiation therapy is just as successful as surgery for treating some kinds of tumors, and it is less likely to damage surrounding tissue. However it should still be used with caution as radiation frequently causes brain swelling that ultimately needs to be treated with steroids.

2. Tumors of the Brainstem 

Brainstem gliomas/tumors are uncommon in individuals living with NF, as they occur in only 10-15% of children ages 5-10 years old. The brain stem connects the brain to the spinal cord. and carries out numerous bodily functions such as maintaining your blood pressure and heart rate, regulating your breathing and plays a role in your alertness. There are also 12 nerves in the brain called "cranial nerves" which are responsible for communicating information between the body and the brain. These nerves are responsible for things such as eye movement; muscle sensation to the mouth, tongue, throat, shoulders, neck and face.

Brain tumors in the brainstem can cause sudden and dramatic symptoms such as:

  • Double vision
  • Clumsiness or difficulties with coordination
  • Difficulty swallowing
  • Weakness or numbing of one half of the body 
  • Changes in behaviour 
  • Unusual sleepiness
Due to the location of the brainstem, surgery is typically not an option to treat this kind of tumor. Instead, aggressive chemotherapy or radiation can be used to treat a brainstem tumor.

Thanks for reading, have a wonderful week!


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