Astrocytoma
An astrocytoma develops from star-shaped glial cells
(astrocytes) that support nerve cells. These tumors can
be located anywhere in the brain, but the most common
location is in the frontal lobe. Astrocytomas are the most
common primary CNS tumor.
The physician, usually the neurosurgeon or neuro-
oncologist, will discuss the type and location of an as-
trocytoma. The pathologist will assign it a grade. Astro-
cytomas are generally classifi ed as low or high grade.
Low-grade astrocytomas (grades I and II) are slow grow-
ing. High-grade astrocytomas (grades III and IV) grow
more quickly. The main tumor type is listed for each grade.
There are additional tumor types in each of these grades.
The WHO classifi cation divides astrocytomas into
four grades:
•  Grade I Pilocytic Astrocytoma
•  Grade II Low-Grade Astrocytoma
•  Grade III Anaplastic Astrocytoma
•  Grade IV  
Glioblastoma Multiforme (or GBM)
CHARACTERISTICS
The characteristics of an astrocytoma vary depending on
the tumor’s grade and location. Most people are function-
ing normally when diagnosed with a low-grade astrocy-
toma. Symptoms tend to be subtle and may take one to
two years to diagnose. This is because the brain can often
adapt to a slow-growing tumor for a period of time. High-
grade tumors may present with changes that are sudden
and dramatic.
SYMPTOMS
•  Headaches
•  Seizures or convulsions
•  Diffi culty thinking or speaking
•  Behavioral or cognitive changes (related to thinking,
reasoning, and memory)
•  Weakness or paralysis in one part or one side of
the body
•  Loss of balance
•  Vision changes
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Questions to Ask

These are ten questions you can ask of your health professional. Be sure to have a notebook ready to write down the answers. These will give you a good starting point if you are unsure of what questions to ask.

1. What is the name and grade of the tumor? Is it a primary or metastatic tumor?

2. Is the tumor benign or malignant?

3. What are the treatment options?

4. What are the possible side effects of each treatment option?

5. Which treatment would you take if you had this tumor?

6. If I am more interested in quality of life rather than how long I live, which treatment would you recommend?

7. Are there any clinical trials for which I am eligible, and what questions are those clinical trials asking?

8. If I wanted a second opinion from another neuro-oncologist or neurosurgeons, whom would you recommend?

9. What factors do you look at to predict how I am going to do?

10. How can I reach you or someone else in your office if I have questions after today?

LOD is associated with right frontal lobe atrophy and loss of the correlation between cognitive performance and brain volume. This adds support to the fronto-striatal hypothesis of depression and suggests that structural brain changes have a particular role in cases of LOD.

CONCLUSION: LOD is associated with right frontal lobe atrophy and loss of the correlation between cognitive performance and brain volume. This adds support to the fronto-striatal hypothesis of depression and suggests that structural brain changes have a particular role in cases of LOD.

A 64-year-old female with no past psychiatric history presented with a two-month history of depressive symptoms. She met DSM-III-R criteria for major depressive episode with melancholia. Physical exam revealed a left-sided Horner's syndrome, and MRI scan of the brain revealed large bilateral frontal lobe masses that were neurologically silent. This case demonstrates that intracranial tumors can present as late onset depression without significant accompanying neurologic deficits.

LOD is associated with right frontal lobe atrophy and loss of the correlation between cognitive performance and brain volume. This adds support to the fronto-striatal hypothesis of depression and suggests that structural brain changes have a particular role in cases of LOD.