Malignant astrocytomas pathophysiology

Pathophysiology
Grade III and grade IV tumors tend to present with symptoms attributable to mass effect, increased ICP and brain infiltration. The exact presentation can be modified by the specific anatomic strictures involved. Involvement of the midbrain and brainstem is more likely to lead to ventricular obstruction and increased ICP. In keeping with the histologic behavior, glioblastoma multiforme tends to present approximately 10 years later than astrocytoma. The symptoms tend to remain static for a number of years and then patients may enter a period of rapid deterioration coinciding with progression of the tumor.

HA and seizures are the most common presenting features and are usually present for several months prior to diagnosis. As expected, the more aggressive tumors have a more fulminant course and are diagnosed sooner from symptom onset and can present with intracranial hemorrhage. Neurologic signs are often found including hemiparesis (61-83%), papilledema (32-66%), confusion (18-40%) and aphasia (25-32%).

These tumors can metastasize through the CNS axis, but rarely invade systemically.