Ependymoma - Symptoms & Causes

What is an ependymoma?

Ependymoma is a type of tumour that originates in the ependymal cells lining the ventricles of the brain and the central canal of the spinal cord. Ependymomas can occur at any age, but they are more commonly diagnosed in children and young adults.

Grades of ependymomas

Ependymomas are graded according to the World Health Organisation (WHO) classification system:

Grade I ependymomas refer to myxopapillary ependymomas and subependymomas, typically slow-growing and found in the conus of the spinal cord
Grade II ependymomas refer to classic ependymomas, which can be relatively slow growing but may recur after treatment
Grade III ependymomas refer to anaplastic ependymomas, characterised by high cellularity, mitotic activity, and malignant behaviour, often leading to rapid growth and a higher chance of recurrence. Occasionally may require radiotherapy after surgical resection for local control.

What are the symptoms of an ependymoma?

Symptoms of ependymoma vary depending on the tumour’s location and size but commonly include:

Headaches, often worse in the morning
Nausea and vomiting
Problems with balance or walking
Neck pain or stiffness
Changes in vision or eye movement
Seizures

In infants, increased head size may be noted due to hydrocephalus, which is an accumulation of cerebrospinal fluid caused by the tumour blocking its normal flow.

What causes an ependymoma?

The exact causes of ependymoma are not well understood. Genetic and environmental factors are considered to play a role, but no definitive causative agents have been identified. Research is ongoing to determine the underlying mechanisms that contribute to the development of these tumours.

The complications associated with ependymoma largely depend on the tumour’s location and may include:

Hydrocephalus, resulting from blocked cerebrospinal fluid flow
Persistent neurological deficits, such as weakness, numbness, or loss of coordination
Learning difficulties, particularly in children affected by brain tumours
Recurrence of the tumour, even after treatment

How do you prevent an ependymoma?

Currently, there are no known preventative measures for ependymoma due to its unclear etiology. Ongoing research aims to better understand the risk factors associated with this condition, which may lead to potential preventative strategies in the future.