Brain Tumors
Tuesday, January 19, 2021- Brain tumor is the collection (or) growth of abnormal cells in the brain, meninges, from the nerve itself, its coverings.
- Brain tumor may be benign (or) malignant.
- Brain tumors may arise inside the brain called as primary tumor, it may spread from other parts of the body called as secondary brain tumor.
- Large percentage of childhood tumor and located in frontal and parietal lobe.
- Brain stem – 10-12%
- Post fossa tumor are 16%
- Glioblastoma most malignant tumor of brain 18% of adult primary brain tumor.
- Meningiomas- 26%, Pituitary tumors- 8%
- Nerve sheath tumor – 6%
- Brain tumors can be benign and malignant
- Primary brain tumors
- Secondary brain tumor
- Benign tumor are slow growing and they donot have cancer cells.
- Benign tumors are completely curable by surgery.
- There benign tumor will not spread to other parts of body.
- They are life threatening due to their size and their presence near important areas of brain.
- Few of the benign tumors can turn into malignancy after some time.
- Malignant brain tumor:
- They are serious and grow fast.
- They will invade surrounding healthy brain very fast.
- Cancer cells can spread to other parts of brain and spinal cord.
Risk factors for brain tumor :
1) Genetic changes
2) Ionizing radiation- high done x-ray can causing cell damage that lead to tumorigenesis.
3) Immunosuppression
4) Cellular phones and hair dyes.
Classification of tumor according to tissue of origin:
a) Glioma-
1) Astrocytoma- low to moderate grade
2) Glioblastoma- highly malignant and invasive.
3) Oligodendroglioma- Benign
4) Ependymoma- May be benign (or) highly malignant
b) Meningioma- Benign (or) Malignant
c) Acoustic neuroma- Benign
d) Hemangioblastoma- Rare and benign
Metastatic tumors.
• Secondary brain tumor also called as Metastatic tumor; they spread to brain from malignancies of other parts of the body through blood circulation.
• Approximately about 24% of systemic cancers develop metastatic brain tumor.
• 80% of them are in cerebral hemisphere.
• 20% of them in posterior fossa.
Frontal lobe is the most consciousness site, followed by parietal lobe for metastatic brain tumor.
• Average survival with metastatic brain tumor is only 6 months for 1 1/2 year.
Symptoms of brain tumors:
• Symptoms depend on location of the tumors, and size of the tumor.
• Most common symptoms of brain tumor are:
• Headache- More in morning hours and progressive headache indicate brain tumor.
• Headache may be symptoms of many other causes, hence to be evaluated.
• Vomiting---> during the time of headache.
• Seizures
• Gait disturbances, problems of balances
• Change in mood, personality and behavior
• Problems of memory
• Changes in speech, vision, heaving.
• Difficulty in concentration, incontinence of urine.
• Numbness/tingling of limbs
• Weakness of limbs.
Headache:
Headache is presenting symptoms in 70% case of brain tumor.
Specific nature of brain tumor headache is
a) Headache that interrupts sleep and progressive headache more in morning hours.
b) Headache that is worse with postural changes, coughing and exercise.
c) Headache associated with vomiting and associated with other neurological signs.
Approximately 15-20% of adult with new onset seizure activity will have brain tumor.
Seizures produced by:
60% of frontal tumor
40% of parietal tumor
40% of temporal tumors.
2) Altered mental status:
15% of brain tumor present as difficulty in concentration, personality changes, changes in memory and cognitive problems.
Diagnosis:
1) Clinical diagnosis and examination is the important part of diagnosis.
2) After the clinical suspects the next step is tumor imaging.
• Non invasive imaging modalities like C.T and MRI with or without contrast are the main investigations for brain tumor.
Contrast enhancement of C.T will help to identify the tumor from surrounding parenchyma and the hypodense surrounding indicates the edematous area of surrounds brain.
MRI Brain:
• MRI is superior to CT in detecting and localizing the tumor.
• MRI is more sensitive modality than CT.
• MRI can be used with contrast gadolinium to differentiate between tumor and oedema.
Some of the andramed dynamic imaging are- positron emission tomography (PET)
Single photon emission computed tomography (SPECT)
Treatment:
Treatment options available are:
1) Microsurgery
2) Chemotherapy
3) Radiotherapy
4) Stereotactic radio surgery
The ultimate goal of tumor management is to improve the quality of life.
Treatment options are depends on type of tumor, grade of the tumor.
Dr. R. Ram Mohan Naik
Consultant Neurosurgeon
KIMS Hospitals, Anantapur.