Patient's question:
How to treat it, what are the factors or causes? Duration and course of the current illness: It has been 2 years. Current general condition: It has improved compared to before, a bit like walking while drunk, with left and right swaying. It is especially noticeable when walking at night. Previous diagnosis and treatment history and effectiveness: At that time, it was thought to be Ménière's disease.Doctor's answer:
Intracranial TumorIntracranial tumors refer to various brain tumors and are one of the common diseases in the nervous system, posing significant harm to the function of the human nervous system. They are generally classified into two major categories: primary and secondary. Primary intracranial tumors can occur in brain tissue, meninges, cranial nerves, pituitary gland, remnants of embryonic vascular tissue, etc. Secondary tumors are metastatic tumors that form in the brain due to the spread or invasion of malignant tumors from other parts of the body.
In recent years, the incidence of intracranial tumors has been on the rise. Statistics show that intracranial tumors account for approximately 5% of all tumors and 70% of pediatric tumors. Additionally, 20-30% of other malignant tumors eventually metastasize to the brain. Due to their expansive and invasive growth, once they occupy a certain space in the brain, regardless of whether they are benign or malignant, they inevitably lead to increased intracranial pressure, compressing brain tissue and causing central nervous system damage, which can be life-threatening.
Intracranial tumors can occur at any age, with the highest incidence observed in individuals aged 20-50. Children are more prone to tumors in the posterior fossa and along the midline, primarily medulloblastomas, craniopharyngiomas, and ependymomas. In adults, gliomas in the cerebral hemispheres are most common, followed by meningiomas, pituitary tumors, and secondarily, neurofibromas, cavernous hemangiomas, and cholesteatomas. There is no significant gender difference in the incidence of primary intracranial tumors, with males slightly more affected than females.
Etiology and Pathogenesis of Intracranial Tumors: Traditional Chinese medicine (TCM) believes that the formation of brain tumors is due to internal injuries such as emotional distress, leading to dysfunction of the zang-fu organs. External pathogens invade, causing a struggle between cold and heat, resulting in the accumulation of phlegm and turbidity in specific parts of the body over a long period. Experts have integrated various theories and, through dedicated research, have summarized the causes of brain tumors into two categories: internal (constitutional or susceptible factors) and external (triggering or promoting factors). However, neither alone can cause the disease. TCM classifies brain tumors under conditions such as "headache" and "headwind." The primary causes are believed to be kidney deficiency, leading to malnourishment of the marrow sea, as the kidneys and liver are interconnected. Kidney deficiency also leads to liver deficiency, resulting in internal wind, pathogenic toxins disturbing the clear orifices, phlegm obscuring and blocking the brain's meridians, and stagnation of blood and qi. The head being the "convergence of all yang meridians" governs human consciousness and is highly susceptible to pathogenic invasions. Exposure to pathogenic factors directly affects the brain or invades the upper, leading to impaired qi transformation, blocked meridians, and the accumulation of blood and turbidity. All pathogenic factors converge on the brain, forming tumors. Molecular biology studies on tumors indicate that two types of genes are closely related to their occurrence and development: oncogenes and anti-oncogenes. The activation and overexpression of anti-oncogenes induce tumor formation, while their presence and expression help suppress tumor development. Oncogenes can exist in normal cells without expressing tumor characteristics. When such cells are exposed to carcinogenic factors such as viruses, chemical carcinogens, and radiation, the oncogenes become activated, the cell phenotype changes, and tumor traits are expressed. These cells rapidly proliferate, forming true tumor masses. Currently, recognized factors triggering tumor formation include genetic factors, physical factors, chemical factors, and carcinogenic viruses.
Common Locations of Intracranial Tumors: The occurrence of intracranial tumors is often related to their type. Gliomas are most common in the cerebral hemispheres, pituitary tumors occur in the sellar region, acoustic neuromas in the cerebellum pontine angle, reticular cell tumors in the cerebellar vermis, and medulloblastomas in the cerebellar vermis.
Clinical Manifestations of Intracranial Tumors: The manifestations vary greatly depending on the pathological type, location, and growth rate. However, there are three common features: 1) increased intracranial pressure; 2) focal lesion symptoms; 3) progressive course.
(I) Symptoms of increased intracranial pressure occur in more than 90% of brain tumor patients and include:
1) Headache, nausea, and vomiting. Headaches are often located in the forehead and temporal regions, persistent, and worsen intermittently, particularly in the morning. Intervals between headaches can be normal.
2) Papilledema and visual impairment.
3) Neurological and mental disturbances: dizziness, diplopia, transient blindness, sudden falls, confusion, mental restlessness or apathy, seizures, and even coma.
4) Changes in vital signs: Moderate to severe acute intracranial hypertension can cause slowed breathing and pulse, while blood pressure rises.
(II) Local symptoms and signs depend on the tumor's location, allowing for tumor localization diagnosis based on the patient's specific symptoms and signs.
(1) Clinical symptoms of cerebral hemisphere tumors:
1) Mental symptoms: Slowed reaction, lethargy, impaired short-term memory, even loss of self-awareness and judgment. Irritability, excitability, or euphoria may also occur.
2) Epileptic recurrence: Includes generalized and focal seizures, most commonly in the frontal lobe, followed by temporal, parietal, and least commonly in the occipital lobe. Some cases may have pre-seizure symptoms, such as hallucinations, dizziness (temporal lobe tumors), or paresthesia (parietal lobe tumors).
3) Pyramidal tract damage symptoms: Weakness or paralysis on the side of the tumor with positive pathological signs.
4) Sensory deficits: Impaired proprioception, two-point discrimination, graphognosis, haptics, and stereognosis on the side of the tumor.
5) Aphasias: Motor and sensory aphasias.
6) Visual field changes: Visual field defects and hemianopia.
(2) Clinical manifestations of sellar region tumors:
1) Visual impairment: Tumor growth into the suprasellar region compresses the optic chiasm, causing visual loss and field defects, often the primary reason for patients seeking medical attention. Fundoscopy may reveal primary optic atrophy.
2) Endocrine dysfunction: Hypogonadism (e.g., impotence and reduced libido in males, prolonged menses or amenorrhea in females). Excessive growth hormone secretion before maturity can lead to gigantism, while after maturity, it causes acromegaly.
(3) Clinical manifestations of pineal region tumors:
1) Tectal compression symptoms: Primarily manifest in two aspects: visual impairment, pupillary light and accommodative response dysfunction, tinnitus, and deafness; ataxia, unsteady gait, horizontal nystagmus, partial paralysis, crossed pyramidal signs; diabetes insipidus, somnolence, obesity, and arrested physical development, with precocious puberty in males.
(4) Clinical manifestations of posterior fossa tumors:
1) Cerebellar hemisphere symptoms: Ataxia on the affected side, weakened or absent muscle tone, delayed knee reflexes, horizontal nystagmus, and sometimes vertical or rotational nystagmus.
2) Cerebellar vermis symptoms: Trunk and distal lower limb ataxia, wide-based gait, or swaying like a drunkard.
3) Brainstem symptoms: Characteristic signs include crossed paralysis, such as third nerve palsy on the affected side (midbrain lesions), lateral rectus palsy and facial muscle paralysis on the affected side (pontine lesions), and contralateral facial sensory loss and auditory impairment (medullary lesions).
(4) Clinical manifestations of cerebellum-pontine angle tumors: Tinnitus, hearing loss, vertigo, facial numbness, facial muscle twitching, facial paralysis, hoarseness, dysphagia, ataxia, and horizontal nystagmus on the affected side.
(III) Progressive course: Tumors may not cause compression symptoms in the early stages, but as the tumor grows, varying degrees of compression symptoms may appear. The rate of tumor growth and symptom progression vary depending on the tumor's location and malignancy.
Treatment of Intracranial Tumors:
Currently, surgery, chemotherapy, radiotherapy, X-knife, gamma-knife, and other treatments are widely used for intracranial tumors worldwide, but most are difficult to cure. Malignant tumors have a short course and rapid progression. Depending on the malignancy level, surgical resection or radiochemotherapy sensitivity varies, leading to early or late recurrence. Tumors in critical areas such as the brainstem or thalamus are difficult or impossible to surgically remove. After X-knife or radiotherapy, tumors may shrink or temporarily control growth before recurring. Benign tumors have a longer course and slower growth, making complete surgical removal less likely to recur. However, tumors in critical areas such as the brainstem can only be partially or mostly resected, with recurrence and regrowth post-surgery. The average survival rate after surgery and radiochemotherapy for intracranial malignant tumors is less than one year. Benign tumors like gliomas, pituitary tumors, craniopharyngiomas, and cholesteatomas are difficult to completely remove surgically. Gamma-knife, X-knife, and radiotherapy cannot completely eliminate tumors, so most patients still recur post-surgery.
An expert team, drawing on the strengths of various theories, has combined TCM's macroscopic holistic treatment with modern medicine's microscopic analysis. Through over 30 years of dedicated research on brain tumors from a TCM perspective, they have gained unique insights into the pathogenesis and treatment of brain tumors, earning attention from the medical community and widespread recognition from society. They believe that while there are many methods for treating intracranial tumors worldwide, most are difficult to cure, and most patients still recur. The occurrence of brain tumors and the resulting varying degrees of headaches, dizziness, paralysis, hearing, and visual impairments are often symptoms of insufficient liver and kidney function. The liver stores qi and blood, while the kidneys store essence, with the latter governing bones and marrow, which connects to the brain. These two systems interact physiologically and influence each other pathologically. To overcome the challenges in treating brain tumors, they have developed a relatively comprehensive advanced anti-tumor theory based on TCM principles, integrating modern medicine. According to TCM theory and combined with both TCM and Western diagnoses, they have carefully studied pathological data and explored traditional TCM formulas. They have established a theory that goes beyond traditional TCM's blood-activating and stasis-resolving methods. Based on the type, location, pathology, and symptoms of the brain tumor, they practice syndrome differentiation and treatment, starting with tonifying the liver and kidneys, calming liver wind, and strengthening the brain through nourishing the kidneys. They also leverage the ascending and descending properties of Chinese herbs to regulate the body's clear and turbid functions, using methods to soften and resolve masses and activate blood circulation. This ensures that Chinese herbs target the tumor, reach the lesion, and promote the regression of tumor cells through sweat, urine, and feces, allowing for targeted treatment and symptom relief. After relentless effort, they have screened dozens of natural Chinese herbal medicines from thousands of options. Through further refinement, processing, extraction, and enhancement, they have developed a series of anti-tumor Chinese herbal medicines for oral administration. These medicines can pass the blood-brain barrier, reach the lesion along meridians, selectively enter the tumor, block blood circulation to the tumor, cut off its oxygen supply, and inhibit tumor cell replication and transcription. This series of medicines has shown significant efficacy in treating various intracranial tumors, including gliomas, pituitary tumors, meningiomas, craniopharyngiomas, cholesteatomas, neurofibromas, pineal tumors, cavernous hemangiomas, neuro,, and brain metastases. They render tumor cells incapable of reproduction, causing the tumor to gradually shrink, calcify, or disappear.