Glial cells > are sometimes called neuroglia or simply glia , they are nonneuronal cells that maintain

homeostasis, form myelin, and provide support and protection for neurons in the brain, and for neurons in other parts of the nervous system such as in the autonomic nervous system. In the human brain there are 10 to 100 glial cells for every neuron. Four main functions of glial cells: to surround neurons and hold them in place to supply nutrients and oxygen to neurons to insulate one neuron from another to destroy pathogens and remove dead neurons.

Types : 1) Microglia are specialized macrophages capable of phagocytosis that protect neurons of the central nervous system. They are derived from hematopoietic precursors rather than ectodermal tissue; they are commonly categorized as such because of their supportive role to neurons. 2) Macroglia Astrocytes > The most abundant type of macroglial cell, astrocytes (also called astroglia) have numerous projections that anchor neurons to their blood supply. They regulate the external chemical environment of neurons by removing excess ions, notably potassium, and recycling neurotransmitters released during synaptic transmission. Oligodendrocytes are cells that coat axons in the central nervous system (CNS) with their cell membrane forming a specialized membrane differentiation called myelin, producing the socalled myelin sheath. Ependymal cells, also named ependymocytes, line the cavities of the CNS and make up the walls of the ventricles. These cells create and secretecerebrospinal fluid(CSF) and beat their cilia to help circulate the CSF and make up the Blood-CSF barrier.

Astrocytoma > arise from small, star-shaped cells called astrocytes, they may grow anywhere in the brain or spinal cord >In adults, astrocytomas most often arise in the cerebrum. In children, they occur in the brain stem, the cerebrum, and the cerebellum > have a tendency to become progressively anaplastic if left untreated, this transformation may be heralded by a rapid clinical deterioration

There are two broad classes recognized in literature, those with:

1) Narrow zones of infiltration (mostly invasive tumors; e.g., pilocytic astrocytoma, subependymal giant cell astrocytoma, pleomorphic xanthoastrocytoma), that often are clearly outlined on diagnostic images 2) Diffuse zones of infiltration (e.g., low-grade astrocytoma, anaplastic astrocytoma, glioblastoma), that share various features, including the ability to arise at any location in the CNS, but with a preference for the cerebral hemispheres; they occur usually in adults; and an intrinsic tendency to progress to more advanced grades.

Pilocystic astrocytoma

Anaplastic astrocytoma

UNKNOWN

1) Radiation exposure: > Some people exposed to high doses of radiation appear to have an increased risk of brain cancer 2) Exposure to certain chemicals: >Oil refining > Rubber manufacturing 3) Hereditary (neoplastic syndromes) > Neurofibromatosis, p53 mutation
male> female caucasians

The first symptoms of astrocytoma, or any brain tumor, can be caused by increased pressure in the brain as the tumor grows

Symptoms may include: Headaches Visual changes Vomiting Seizures Personality changes Problems with memory, thinking, and concentration Problems with walking Symptoms will vary, depending on the location of the astrocytoma: Frontal lobe - gradual changes in mood and personality, paralysis on one side of the body Temporal lobe - problems with coordination, speech, and memory Parietal lobe - problems with sensation, writing, or fine motor skills Occipital lobe - problems with vision, visual hallucinations Cerebellum - problems with coordination and balance

WHO Grade

Astrocytomas Pilocytic astrocytoma ,pleomorphic xanthoastrocytoma, subependymal giant cell astrocytoma, and subependymoma

Description Consist of slow growing astrocytomas, benign, and associated with long-term survival. Individuals with very slow growing tumors where complete surgical removal by stereotactic surgery is possible may experience total remission.

II

Low-grade astrocytoma, mixed oligoastrocytoma

Consist of relatively slow-growing astrocytomas, usually considered benign that sometimes evolve into more malignant or as higher grade tumors. They are prevalent in younger people who are often present with seizures. Median survival varies with the cell type of the tumor. Grade 2 astrocytomas are defined as being invasive gliomas, meaning that the tumor cells penetrate into the surrounding normal brain, making a surgical cure more difficult. Due to the infiltrative nature of these tumors, recurrences are relatively common. Depending on the patient, radiation or chemotherapy after surgery is an option. Individuals with grade 2 astrocytoma have a 5-year survival rate of about 34% without treatment and about 70% with radiation therapy. The median survival time is 4 years.

WHO Grade

Astrocytomas

Description Consist of anaplastic astrocytomas. It is often related to seizures, neurologic deficits, headaches, or changes in mental status. The standard initial treatment is to remove as much of the tumor as possible without worsening neurologic deficits. Radiation therapy has been shown to prolong survival and is a standard component of treatment. Individuals with grade 3 astrocytoma have a median survival time of 18 months with treatment (radiation and chemotherapy). Consists of Glioblastoma multiforme (GBM), which is the most common and most malignant primary brain tumor. Primary GBM grow and spread to other parts of the brain quickly; they can become very large before producing symptom, which often begin abruptly with seizures. Less than 10% form more slowly following degeneration of low-grade astrocytoma or anaplastic astrocytoma. These are called secondary GBM and are more common in younger patients (mean age 45 versus 62 years). "Surgical removal remains the mainstay of treatment, provided that unacceptable neurologic injury can be avoided. The extremely infiltrative nature of this tumor makes complete surgical removal impossible. Few patients survive beyond 3 years. Individuals with grade 4 astrocytoma have a median survival time of 17 weeks without treatment, 30 weeks with radiation, and 37 weeks with surgical removal of most of the tumor followed by radiation therapy. Long term survival (at least five years) falls well under 3%.

III

Anaplastic astrocytoma

IV

Glioblastoma multiforme (GBM)

Complications of astrocytoma include: Brain herniation Coma Loss of communication skills Permanent neurologic impairment The loss of the ability to perform basic self-care Complications associated with treatment