Neuro Surgery

What is Brain tumor ? What is neuro surgery ?

Neuro surgery – Brain tumor

Primary brain tumours are tumours that start in the brain. They can be cancerous (malignant) or not cancerous (benign). Find out how brain tumours are diagnosed, treated and how they might affect your life. (description)

When normal cells lose the ability to grow old and die, they become abnormal and continue to grow. Large numbers of such abnormal cells form a mass, called as tumors. When these masses are found in the brain, they are called brain tumors. Tumors can either be benign or malignant.

Benign tumors can be removed and do not have any cancer cells. Also, once removed, they are not likely to form again. These tumors do not spread to other parts of the brain and are localized, having clear borders. However, their unchecked growth can press against the normal cells and cause symptoms.

Malignant tumors are those that have cancer cells, interfere with the regular functions of the brain and are life threatening. Such tumors also show aggressive growth, and also spread to the surrounding tissues.

Brain tumors are also generally separated into two categories:

Primary Brain Tumor: those which develop within the brain itself. There are several subtypes, based on the type of cell from which they originate, such as glial cells, neuronal cells, meningeal cells, or Schwann cells.

Metastatic Brain Tumor: those that spread from other parts of the body to the brain. All metastatic tumors are considered malignant, and depending on the type of the primary tumor site, they behave differently. The most common types of metastatic tumors are: lung cancer, breast cancer, renal cell cancer, melanoma, and colon cancer.

Brain tumors are graded in 4 stages: from Grade I (low grade) to Grade IV (high grade). The grading is done after a pathologist looks at the cells. Higher grade tumors are more abnormal looking, grow faster, and are more malignant, as compared to lower grade tumors.


How is a brain tumor treated? What are the different treatment options available?

The decisions regarding brain tumor surgeries are made by your cancer care team, before they give you your options. Surgeons, pathologists, medical and radiation oncologists discuss each specific tumor and plan a treatment option.

Your doctors may prescribe surgery, radiation, chemotherapy or a combination of these three, as a part of your specific treatment plan. Surgery involves removal of the tumor and patients are observed for 2 – 3 days following surgery. Some tumors such as astrocytoma, GBM, ependymoma, medulloblastoma are infiltrative tumors and therefore, even after complete removal using surgery, some traces of the tumor may remain.

Fractionated radiation therapy, is another form of treatment, which may be used to deal with the remaining traces of the tumor.

Radiosurgery, is used for benign and metastatic tumors. Here, a very high dose of radiation (only once) is delivered to the tumor, while keeping the surrounding normal tissues safe. Usually radiosurgery is prescribed only for small tumor masses (less than 3cm, in diameter), easily identified by MRI or CT scans, and separate from the brain. For patients with a tumor that can be treated with radiosurgery, the procedure gives very little discomfort and only a short time to recover fully.


How does your doctor diagnose it?

First, your doctor will collect your family and your individual medical history, followed by a complete physical exam. Along with this, they will also perform a neurologic exam – including checks for muscle strength, co-ordination, reflexes, and response to pain. They also examine the eyes to look for a swelling cause by tumors pressing on the nerve that connects the eye and the brain. Based off the results, your doctor may recommend one or both of the following:

ACT (or CAT) scan gives detailed pictures of the brain. A computer is linked to an X-ray machine, which provides the pictures. Sometimes, a dye is injected into a vein before the scan, which helps to show differences in the tissues of the brain.

AMRI (magnetic resonance imaging) scan gives pictures of the brain as well. However, it uses a powerful magnet linked to a computer. Unlike CT, MRI scans do not need any radiation. MRI is very useful in diagnosing brain tumors because it can see the tissues lying underneath the bones of the skull. Here too, a dye may be used to increase the chances of detecting a brain tumor.

Your doctor may also recommend performing other tests as well, such as:

  1. Skull X-ray: can show changes in bone structure of the skull due to a tumor. Calcium deposits, a feature of some brain tumors, can also be detected using this method.
  2. Angiogram/ Arteriogram: Multiple X-rays are taken after a dye is injected into an artery. The dye flows through the blood vessels of the brain, and can be seen on the X-rays, which show the tumor and the blood vessels that lead to it.
  3. Myelogram: This is an X-Ray of the spine. Here too, a dye is injected into the fluid of the spine (cerebrospinal fluid), and is allowed to mix. This test is generally performed if your doctor suspects a tumor in the spinal cord and is followed by a CT scan to assess the dye flow.

Do you need a second opinion?

Since treatments are continuously improving, we think that it is important for you to be advised by the best doctor in the field, who has experience with your type of tumor. A second opinion is where you meet with more than one doctor to confirm your diagnosis and also, to understand your treatment options.

Second opinions are quite common and most people follow this practise, as it may help to feel more comfortable about your health and the future decisions you make.

Asking for a second opinion is common practice. It may help you feel more comfortable with the health care decisions you make. There are various ways in which a second opinion can give you information. It can:

  1. Confirm your diagnosis
  2. Provide more details about the type of brain tumor, and its current stage
  3. Give an accurate location for your cancer, and whether or not it has spread (metastasis)
  4. Tell you whether other parts of your body are being affected
  5. Put you in touch with experts in associated fields of oncology who can inform you of other details, such as medical, radiation, and surgical oncology
  6. Also give you other treatment options, in case the doctor disagrees with your prior diagnosis and treatment

What are the signs and symptoms of brain tumors?

There are several symptoms of brain tumors, brought on by a number of factors, such as size, location of the tumor, as well as growth rate. Symptoms may be caused by damage to tissue or by pressure on the brain as the tumor grows within the space in the skull. Symptoms may also be caused by swelling and a build-up of fluid around the tumor, called edema. If the rate of growth of a brain tumor is very slow, the symptoms may appear so gradually that they are overlooked for a long time. Also, brain tumor symptoms are often quite vague and non-specific.

The most common symptoms of brain tumors are:

  1. Headaches that are worse in the morning and get better during the day
  2. Confusion or personality changes
  3. Seizures (convulsions)
  4. Nausea or vomiting
  5. Weakness or loss of feeling in the arms or legs
  6. Stumbling or lack of coordination in walking
  7. Abnormal eye movements or changes in vision
  8. Drowsiness
  9. Changes in speech

Symptoms are usually slow and progressive in nature.

What type of brain tumor is it?

There are several types of CNS tumors, each with different symptoms, and treatment options. You can browse our list as below:

  • Adult Brain Tumors
    1. Gliomas
    2. Anaplastic astrocytoma (grade III glioma)
    3. Low-grade astrocytoma (grade II glioma)
    4. Pilocytic astrocytoma (grade I glioma)
    5. Oligodendroglioma
    6. Ependymoma
    7. Mixed Glioma
  • Pediatric Brain Tumors
    1. Medulloblastoma
    2. Glioblastoma (grade IV glioma)
    3. Astrocytoma
    4. Ependymoma
    5. Brainstem glioma
    6. Craniopharyngioma
    7. Spinal cord tumors
  • Skull Base Tumors
    1. Meningiomas
    2. Acoustic neuroma (vestibular schwannoma)
    3. Pituitary Adenomas
    4. Nasal carcinomas
    5. Chordomas

What is neurology? What is neurosurgery?

Neurology is the study and treatment of diseases of the nervous system. Doctors who practice neurology called as Neurologists. Neurosurgery is surgery performed on parts of the nervous system, such as the brain and spinal cord. Doctors who perform the surgery are called neurosurgeons.


Who are your neurosurgery care team?

If you have a neurologic cancer (CNS cancer), your care team will have surgeons specialized in brain and nervous system surgery, a radiation oncologist, medical oncologist, pathologist, psychologist, rehabilitation therapist and other cancer experts. The neurosurgical team will then review your symptoms with you and obtain a history of your health. Advanced imaging technology, such as MRI, PET scans and/or CT scans, will be used to evaluate the tumor. Biopsies may also be taken, or in urgent cases, full removal of the tumor. Once the team determines the location, type, and grade of the tumor, they will plan a personalized treatment plan for you.


How can MedisenseHealth.com help you? How do we connect the best neuro surgeon or neuro surgery hospital for you?

We at Medisensehealth.com, can help you by finding the top doctors specializing in your kind of neurosurgery. We have a group of 50 specialists who would give an unbiased opinion to you. We also work with the best of the specialized neurology centres in India to bring you the best. All you have to do is follow the links provided, or call our health care support and we will be able to schedule you for a second opinion with the best doctors in the field.

We do require that you give us complete details regarding your ailment. This includes all your medical records—including test results, such as blood work or imaging tests. Using these as our guide, we then narrow down the field of doctors so that, we are able to provide you with the best health care opinion.

Also see, How to Find a Doctor for your Second Opinion with MedisenseHealth.com. Click here


What are the risk factors for brain tumors ?

There are no specific reasons as to why brain tumors occur. Although several studies have been completed in this field, a single dominant risk factor has not yet emerged for the formation of brain tumors. As with most cancers, old age is a factor here as well, but no environmental or genetic factors have been implicated yet, for these tumors. Therapeutic radiation is so far an exception, with studies showing it leading to an increase of the risk of brain tumors. The disease is probably the result of several factors acting together.


Follow-up

Following brain tumor treatment, most patients will need continuous follow-up, including exams and MRI brain scans to evaluate for recurrence or other long-term effects of the tumor or treatment.


Where Do We Get Our Information From?

NIH Brain Tumor Information

http://www.c ancer.g ov/types/br ain

Medlin ePlus Brain Tumor Information

https://www.nl m.nih.gov/medlineplus/brai ntumors.html

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