All cells in a body are structured following the same pattern: they have a nucleus that contains chromosomes and genetic material with chains of DNA, a gelatinous cytoplasm with mitochondria to create energy and ribosome for protein synthesis. Each cell in a body has an identical number of chromosomes, 46 for a human. In addition to the fact that they have the characteristics of a body system and it controls the transfer traits from one generation to another, chromosomes and DNA manage the very cell that contains them. In spite of the fact that cells have the same basic pattern, they inexplicably specialize during the development of the body system. In reference to the nervous system, we notice that this one owns a discrete, discontinuous structure. From a histological point of view, the nervous system consists of cellular elements, representing 75% of the entire mass of the nervous tissue (35% neuronal cells and 40% neuroglial cells), of intermediary non–cellular substance (extra–cellular fluid with low–molecular elements) that represents 15%, and of the blood vessels network that occupies 10%. These proportions vary significantly depending on the nervous tissue characteristic: white substance or grey substance, central segments etc. (⁹, ¹⁰).

The key to the nervous system strategies is based on subdivision and on functions location. In the brain, the specific aspects of the informational processing are limited to certain specific regions. For instance, each sensorial possibility is processed in a distinct region sensorial connections are precisely represented, in the shape of a map of the corresponding body area. Muscles and movements are also represented in an ordered sequence of connections. Thus, the brain contains at least two types of maps: a type for the sensorial perceptions and another one for the motor commands [²]. Nervous cells differ from the other cells of the body in that they can communicate rapidly ones with the others, sometimes at great distances but very accurately. This rapid and accurate communication is possible due to the signaling mechanisms–axonal conduction and synaptic conduction [²²].

In spite of the anatomic differences–micro and macroscopic, the nervous system constitutes a unitary functional mechanism, that completes one type of activity–reflexive activity–as a physiologic or psychic response (physiologically mediated) to the stimuli in the interior or exterior world of the body system. Hence, we cannot talk about neuronal formations having exclusively physiologic function or exclusively psychic function. To understand this behavior, we need to consider the highly complex way the nervous system is functionally and anatomically organized [²].

The modern oncology data show that the malign process occurs on those tissues that have previously undergone certain pathological mutations: inflammatory, proliferative, dystrophic, irritant, and traumatic. What characterizes these preliminary lesions is the fact that they do not tend to regress, but they form ‘pre–cancerous lesions’. Exogenous and endogenous factors, of general or local kind, radically intervene and modify the type of metabolism of the said tissues, modifying their biochemical and cellular structure, causing metabolic and tumor structural characteristics in them, characteristics that are called cancerous factors. Still, the clinical remarks show that, in numerous cases, these two conditions (pre–cancerous lesions and cancerous factors) are not sufficient for the intracranial tumors to clinically manifest. These may be latent for a long time and only the occurrence of a third kind of triggering factors will cause the clinical phase accompanied by all characteristic symptoms to happen [¹⁰].

Incidence of cerebral tumors, versus the other tumor diseases of the body system, is estimated to correspond to 8% out of which 25% represent cerebral metastases as a percentage that, lately, has been increasing continuously. In children, cranial–cerebral tumors represent the second malignity cause after leukemia [⁹, ⁵]. Once the CT–scan and the MRI have been established as a routine check, cranial– cerebral tumors can be diagnosed more rapidly and more accurately as far as the histopathology specificities are concerned but their incidence impressively increased in the last 15 years, in all ages, twice more frequent in men.

Location is approximately 2/3 supratentorial (in order of frequency: frontal, temporal, parietal, intra– ventricular, and of basal nuclei) and of 1/3 subtentorial with predominance in children (70%).

The cranial–cerebral tumors symptomatology depends on age, location and their nature; it can fell into two significant groups:

1. Symptoms caused by the increase in the intracranial pressure: headache, throwing–up, papillary edema.
2. Symptoms caused by the lesion location and constituted by the multitude of neurological, irritant and/or defective signs.

The starting point and the evolution are usually slow, progressive, gradually building up neurological signs that are revealing for a cerebral location, against a clinical background of intracranial hypertension. Tumors can appear all of a sudden only in the case of intra–tumor bleedings or in the case of intra–tumor cists occurrence. The high tolerance manifested by the nervous system as far as their appearance is concerned causes the neurological focal syndrome to be minimum. If they are not diagnosed at the beginning, surgical treatment will be delayed and the continuous evolution will lead to a gradual recurrence of the CNS structures, the neurological deficit irreversibly increasing (plegia, aphasia, blindness, deafness etc.) and causing the self–consciousness state to turn from sleepiness to coma.

Prognosis is influenced by the histological structure of tumor, most of the times in a gray manner since the majority are neuroectodermal tumors (75%) and some of them manifest an increased malignity or can be extremely obtrusive; as far as the median tumors are concerned, surgical accessibility is difficult.

Treatment of CCT is a complex one if a complete recovery from these serious lesions is to be attained.

1. Surgical–since tumors are processes that replace spaces, they endanger directly a patient's life not only by their histopathological nature but also by their presence in the brain cavity. Surgery must start from certain principles: complete abscission, causing no injuries to the adjacent vascular–nervous structures and recovering the circulation ways of the cephalo–rachidian fluid (CRF). Recent data show that mortality strictly intra–surgical is less than 3%. The principle of complete abscission cannot be always attained because of the surgical technical difficulties; in this case, partial abscissions being targeted in order to prolong or save a patient's life. Sometimes, surgical attitude must be limited to palliative interventions that will solve only intracranial hypertension (draining of the cephalo– rachidian fluid), while radiotherapy will be used in order to stop the tumor from growing. Stereotaxic biopsy has been greatly used in the last decade for the histological type of tumor to be established, being followed by surgical removal by means of craniotomy or radiotherapy and guided by CT–scan or MRI.
2. Radiotherapy has a favorable effect on radio–sensitive tumors such as the medulloblastoma, ependymoma.
3. Cytostatic chemotherapy is helpful in CCT grade Ⅲ,Ⅳafter the surgical and radiotherapy treatment had been applied, in order to avoid recurrences and dissemination thru CRL.
4. Corticotherapy reduces brain metabolism of glucose.

The results of multi–way treatment in CCT must be observed continuously both clinically (ex. Neurological) and paraclinically (CT–scan, repeated NMR) accompanied by a general haematological and biological check. Healing is considered after 10 years of following–up.

Recurrences call for another mandatory surgical intervention. From the beginning, one must differentiate the actual tumor growing recurrences of the subtotal ablated tumor by means of CT–scan and repeated MRI which evince tumor reappearance before the neurological signs show up. A new intervention in malign gliomas depends on many factors: histopathological structure, patient's age, his/her clinical condition (determined by the Karnofsky score).

TIC metastasis. Actual cerebral tumors do not cause metastasis. Gliomas can attain, after surgery, a regional invasion thru contiguity. Some cerebral tumors (ependymoma, pinealoma, malign astrocytoma) can be spontaneously introduced by liquid way by means of tumor fragments detached after cranial–cerebral trauma or after surgeries for tumor ablation. Neoplastic cells are frequently introduced even opposite the CRL circulation, as a result of the presence of the tumor, to which regular physical efforts (even the respiratory movements) or those of the surgical intervention kind or the hypertonic substances infusion are being added.

The exceptional diversity of cerebral lesions, as well as the great severity of motor, sensorial and psychic difficulties that they drag along, calls for a most immediate and most accurate diagnosis so that the chance of survival of the minor lesions patients to increase.

The interest shown as to the psychic disorders manifested in cerebral tumors is very important, although it is said that the possibility for a cerebral tumor to cause psychic distresses in a patient is rarer for a psychiatrist than for a neurologist. If many patients suffering from cerebral tumors often show, during their development, noticeable psychic disorders–from 10% up to 100%–depending on the attention paid while they are reached and recorded, as well as on the development stadium of the tumors at the moment of the examination, there are also cerebral tumors with the patients suffering from psychic illnesses, meningiomas and gliomas being the most frequent types.

During the development of the cerebral tumors, psychic disorders are characterized by a start and by a clinical picture that depends on the nature, location and developmental behavior of the tumor; they are accompanied by neurological signs in the shape of a global cerebral distress or of a focal syndrome, that can point to the tumor's location.

As far as the etiopathogeny is concerned, no connections between the tumor material and the psychic phenomenology could be established, the evolutionist character of the lesion impeding the possibility of establishing precise clinical–pathological correlations. Pre–morbid personality as well as predisposition of the field seems to play a major role. There are no precise data as to the way changes in the cephalo–rachidian fluid, circulatory changes, global distress through ICH (IntraCranial Hypertension) influence psyche differentially in proportion to direct effects of tumor lesion. The overall distress of the brain, due to tumor toxic effects or ICH, causes general psychical disorders, and the consequences for tumor location trigger psychical focal disorders (moria, the Gerstmann syndrome, spatial agnosia etc.)[¹¹].

Bagdasar and Arseni (1951) noticed, as far as the frontal tumors are concerned, in case the tumor is small and it grows in the very cerebral parenchyma, an exaggeration in premorbid personality along with central, discrete, contralateral facial paresis. Moria occurs only when, as a result of growing, tumor compresses the frontal lobe on the opposite side, revealing traits that are opposed to the premorbid personality (accompanied by a contralateral hemiparesis). When the basal nuclei are compressed, the confusion state, somnolence, and gatism manifest (contralateral hemiparesis and hemiplegia, signs of pyramidal ipsilateral inflammation). Aggressiveness, restlessness are also specific signs of frontal locations.

Positive diagnosis is determined by identifying:

1. A narrowing in consciousness field, given in 1/3 of cases, initially a slight narrowing, while a confusion or confusion–oneiric state of different intensities subsequently develops.
2. Apathetic state, based on which irritability and a pronounced emotional lability show up, and which is not always explained psychologically; euphoria rarely occurs, while sadness signs are more frequent (it differs from depression).
3. A gradual deterioration of intellectual functions : decline in the capacity for abstraction, synthesis and analysis, bradypsychia, failure of correlations, leading towards the chronic psycho–organic syndrome (the risk of a false diagnosis with senile or arteriopathic dementia).
4. The delirious syndrome, slightly systematized, is more rarely found but acute psychotic episodes are also likely to occur.
5. Hallucinatory seizures: visual, auditory, olfactory, sometimes taking the shape of an aura or an equivalence of a comitial seizure.
6. Paroxystic alteration in consciousness: uncinate seizures with ‘dreamy state’ or ‘absences’ with motor automatisms.
7. Seizures of confusion state worsening, up to coma.
8. Secondary comitial seizures.

Intracranial hypertension (ICH) syndrome can occur before or after the focal signs. Usually, it initially manifests remission episodes, but it gradually becomes permanent, only to end in coma and exitus. It includes:

1. Somatic symptoms: headaches, nausea, vomiting, papillary edema, bradycardia and bradypnea, generalized convulsive seizures.
2. Psychic symptoms: mental confusion and dysmnesia. Mental confusion involves alertness and psychic rhythm, due to a diencephalic touch and it less affects the elementary intellectual functions. Dysmnesia is given in 1/3 of cases, it is more frequent in elderly persons and it may get to the Korsakov syndrome itself; allegedly, it is due to damage through ICH of nervous centers located in the third ventricle's floor.

They mention the positiveness of the neurological exam in 83% of patients considered ‘psychic’ persons having, in reality, cerebral tumors, which calls attention to the necessity of undergoing a thorough neurological exam, with use of modern means of diagnosis (cerebral CT, cerebral NMR, CT–scan etc) [⁸]. Observing patients after tumor ablation usually showed psychic disorders relief. After–surgery sequels may occur in the shape of over–added psychic disorders in a patient that did not manifest them or vaguely manifested them prior to surgery (for instance, paranoid delirium, atypical depressive condition). In corpus callosum tumors, psychic disorders have a 100% incidence, with a characteristic aprosexia. Subtentorial tumors manifest an early ICH, and they are characterized by paroxystic anguish seizures. Tumors located at the brain base are not related to characteristic psychic disorders

The homeostasis concept, foreshadowed by Claude Bernard (between 1870–1880), naturalized by Cannon (1932), enhanced by Henry Selye (1936), has been deeply rooted by modern biology, including in point of cybernetics. Wittenberger shows that homeostasis is an essential feature of biology and of life on the whole and that the homeostatic functions of balance– stability, and of optimization–adaptability, also condition the organism autonomy process in regard to the environment and its active intervention on environment. In certain author's points of view [¹⁷] who drafted the cognitive theory of psychic stress, this one is caused by a discrepancy between a person's resources, abilities, capabilities and the requests enforced on him/her.

Mihai Golu defines psychic stress as: ‘a tension, strain and discomfort state caused by affectable agents with negative significance, resulted from frustration or suppression of certain motivational states, from the difficulty or impossibility of solving certain problems’ [⁴ ].

It is said that psychic stress has a primary attribute when it is the result of an attack perceived in the psyche area and a secondary attribute, this one representing in fact a supplemental reaction or an awareness reaction regarding a biological, physical etc. stress, which is endowed with a threatening significance.

Looking through the specialized literature (¹; ⁶; ⁷; ³; ¹⁹; ²⁰; ²⁷; ¹⁴; ²⁵, ²⁶), one can state that, in order to get settled, psychic stress involves perception, acknowledgement and interpretation by the human individual, in a manner that is strictly particularized and catastrophic, requesting a mandatory interaction with a stimulus in a social context. Hence, we get to the occurrence of important interindividual differences in reactions to stressful situations, the irrelevance of interrelating measuring psychological criteria with various physiological signs of stress as well as the occurrence of clear differences between natural conditions and the laboratory ones in generating stress.