Brain Tumour

What is Brain Tumour?

A Brain Tumor is a abnormal tissue mass growing in any part of the brain. Some brain cells grow in an uncontrolled manner and form these tumour. These tumours can arise from any part of the brain, spinal cord or nerves. The tumour can cause pressure/mass effect on the normal brain and interferes with normal mental and bodily functions.

The Tumour can be slow growing benign tumour or rapidly growing malignant tumours.

Malignant tumours are agin classified ino different grades by WHO. Higher the grade the rapid is the growth rate of tumour.

Types of brain tumour depend on the cell of origin of tumour. Different benign types include Meningioma (arising from Dura),Schwanoma( arising from Schwann cells).

Different malignant types include Glioma(arising from Glial cells),Ependymoma (arising from Ependymomal cells),medulloblastoma.

Usual Locations of Brain tumours

Brain tumors can form in any part of the brain, but there are certain regions where specific tumors form:

• Meningiomas form in the meninges, the protective lining of the brain.
• Pituitary tumors develop in the pituitary gland.
• Medulloblastoma tumors arise in posterior fossa.
• Skull base tumors grow on the underside of the brain, called the skull base.
• Pineal gland tumours
• Choroid plexus tumours
• CP angle tumours
• Ventricular tumours

Symptoms-

General signs and symptoms caused by brain tumors may include:

• Headache or pressure in the head that is worse in the morning.
• Headaches that happen more often and seem more severe.
• Nausea or vomiting.
• Seizures
• Eye problems, such as blurry vision, seeing double or losing sight on the sides of your vision.
• Losing feeling or movement in an arm or a leg.
• Trouble with balance.
• Speech problems.
• Feeling very tired.
• Confusion in everyday matters.
• Memory problems.
• Having trouble following simple commands.
• Personality or behavior changes.
• Hearing problems.
• Dizziness or a sense that the world is spinning, also called vertigo.
• Feeling very hungry and gaining weight.

Brain tumors that aren't cancerous tend to cause symptoms that develop slowly. Noncancerous brain tumors also are called benign brain tumors. They might cause subtle symptoms that you don't notice at first. The symptoms might get worse over months or years.

Cancerous brain tumors cause symptoms that get worse quickly. Cancerous brain tumors also are called brain cancers or malignant brain tumors. They cause symptoms that come on suddenly. They get worse in a matter of days or weeks.

Evaluation

• CT Brain
• MRI Brain with contrast
• PET scan if needed

Treatment

Surgery is the usual treatment for most brain tumor. To remove a brain tumor, an opening is made in the skull. This operation is called a craniotomy. Whenever possible, attempt is made to remove the entire tumor, But if the tumor cannot be completely removed without damaging vital brain tissue, removal of as much tumor as possible is carried out. Partial removal helps to relieve symptoms by reducing pressure on the brain and reduces the amount of tumors to be treated by radiation therapy or chemotherapy.

Stereotactic Biopsy

Some tumors cannot be removed much, therefore in those cases only a biopsy is required. A small piece of the tumor is removed with stereotactic guidance, that a pathologist can examine it under a microscope to determine the type of cells it contains. This helps to decide the treatment of tumour.

Awake Craniotomy

In some cases of tumour, if the lesion is in the vital area of the brain, Awake craniotomy with intra operative neuromonitoring is preffered to remove the lesion. This helps in minimizing the functional loss post surgery.