Ependymoma

What Is It?

An ependymoma is a type of brain tumor that arises from cells that line the ventricles of the brain and the central canal of the spinal cord. The ventricles are fluid filled spaces inside the brain. There are four ventricles, two lateral ventricles, the 3rd ventricle and the 4th ventricle. An ependymoma can arise in any of these areas since all of them are lined with ependymal cells (the name for the cells lining the venricles).

These tumors are in the class of brain tumors collectively called Gliomas, because they arise from glial cells. Glial cells can be thought of as "helper" cells in the brain, helping the nerve cells to do their job properly. Generally, no clear cause for these tumors has been found. They can occur in any of the ventricles or in the spinal cord. Occasionally, after originating in one place, they spread to other areas through the cerebrospinal fluid, the liquid that is inside and surrounding the brain and spinal cord. Both adults and children can develop an ependymoma.


What Types of Symptoms Are Typical?

Symptoms vary considerably depending on the location of the tumor and its size. However, because of their common location within the ventricles, as these tumors enlarge they can block the normal flow of the fluid in the ventricles. This leads to a back up of fluid pressure which is termed hydrocephalus. If a patient does have hydrocephalus it can cause headaches, nausea and vomiting. More severe or prolonged pressure increases can lead to problems with vision and even lethargy and coma in severe cases. Other symptoms vary depending on the site of the tumor.


How Is The Diagnosis Typically Made?

Generally, after a general neurological examination, additional testing is required to diagnose ependymoma. Some form of imaging, either CT scan or MRI scan with contrast dye, is used to get a picture inside the head and brain. These studies are generally very effective in detecting a brain tumor. Sometimes a spinal MRI is also needed to look for any tumor in the spinal canal.

However, while the appearance on these scans can suggest an ependymoma, the diagnosis cannot be definitively made without a sample of tumor tissue which the pathologist examines. This can be accomplished through a biopsy or a full surgical removal of the tumor depending on what is indicated in the specific case.

Occasionally, a lumbar puncture will be performed. This test, also known as a spinal tap, includes numbing the skin of the back and inserting a needle into the spinal canal to remove a small amount of fluid. Because these tumors can sometimes spread through this fluid, the sample can be analyzed for tumor cells to help make the diagnosis.


What Are Some Common Treatments?

The treatment of any brain tumor depends on many factors. Generalizations cannot be made. the neurosurgeon treating the patient will typically discuss the treatment options with other physicians and the patient to determine what treatments are best in each case.

However, some of the common options include medications, surgery to biopsy or remove the tumor, radiation treatment and chemotherapy. Which are appropriate depends completely on the specifics of each case. In the case of hydrocephalus, some patients will require a shunt, which is a treatment for hydrocephalus to decrease the pressure of liquid in the head.



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Important Note: This site is not intended to offer medical advice. Every patient is different, and only your personal physician can help to counsel you about what is best for your situation. What we offer is general reference information about various disorders and treatments for your education.

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