Neurosurgery Dr. Stoforou

BRAIN TUMORS AND BRAIN CANCER

BRAIN TUMORS AND BRAIN CANCER

What is a brain tumor or head tumor?

Tumors in the brain region are basically masses of varying size and composition which develop within the cranial cavity.

What is the differentiation among head tumors?

Brain tumors are distinguished:

1. Depending on their disposition, in:

  • Benign tumors, which usually develop slowly
  • Malignant tumors, which usually develop rapidly, compress or invade adjacent tissues, intensifying any damage / symptom.

2. Depending on their origin, in:

  • Primary, which are tumors derived from intracranial structures (brain, cerebral membrane / meninges) and
  • Secondary or metastatic, which are tumors derived from metastasis of tumors from other parts of the body.

3. Depending on their location in:

  • Supratentorial  – located at the top of the cranial cavity
  • Infratentorial  – located in the lower part of the brain.
  • Intra-ventricular – located in the ventricular system of the brain.
  • Pituitary gland – derived from the pituitary gland.
  • Cranial base – arising from structures located at the base of the cranial cavity, under the brain.

Characteristics such as size, anatomical position, and growth rate of the tumor determine the type of symptoms that will occur and the destined course of treatment.

Brain tumors symptoms

Typically, the main symptoms include:

 

  • Strong headache that persists despite the use of analgesic drugs (pain killers)
  • Vision problems (dazzle, diplopia)
  • Difficulty in speaking
  • Poor hearing or deafness
  • Dizziness
  • Standing and walking instability
  • Vomiting
  • Sensory disorders
  • Motion disorders
  • Confusion, difficulty concentrating.
  • Changes in behavior.
  • Epileptic seizures
  • Cranial nerve palsy
  • Muscle weakness of one limb or of one side

Brain tumors and diagnostic approach.

A detailed neurological examination is the cornerstone of a full diagnostic approach procedure. The rapid technological advancements in diagnosis provide us with numerous high precision technologically advanced pre-operative diagnostic tools designed for an accurate pre-operative diagnosis.

 

Based on the indications, one or more of the following diagnostic tests will probably be recommended:

  • Computed tomography scan (CT Scan)
  • Computed tomography scan (CT Angiography)
  • Magnetic resonance imaging (MRI)
  • Magnetic Spectroscopy (NMR Spectroscopy)
  • Magnetic angiography (MRA)
  • Digital brain angiography (DSA)
  • Magnetic Tractography
  • Functional MRI
  • Positron Tomography (PET SCAN)

However, despite of the accuracy of the paraclinical examinations, the final diagnosis is only feasible after taking a sample, i.e. a biopsy, from the tumor and running a histopathological analysis. The sample is either taken by performing a simple biopsy or during the surgical removal of the tumor.

Brain tumors differentiation on the basis of their origin.

As already mentioned, brain tumors are differentiated on the basis of their clinical, imaging and histopathological properties.

Primary brain tumors

Depending on the type of cells they emerge from, the most common types of brain tumors are the following:

  • GLIOMA BRAIN TUMOR – a tumor arising from the glial cells of the brain depending on its origin and level of malignancy it is distinguished in astrocytoma, oligodendroglioma, lymphoma, glioblastoma, myeloblastoma. These tumors account for 50% of brain tumors.
  • MENINGIOMA BRAIN TUMOR – a tumor arising from cells of the arachnoid meninges, which is the intermediate envelope of the brain. They account for 20% of brain tumors.
  • PITUITARY ADENOMA BRAIN TUMOR – a tumor arising from the pituitary gland. These tumors account for 8% of brain tumors.
  • ACOUSTIC NEUROMA VESTIBULAR SCHWANNOMA BRAIN TUMOR – a tumor arising from the vestibular nerve (VIII cerebral conjugation). These tumors account for 4% of brain tumors.

Metastatic brain tumors

These are tumors which derive from the migration of cancer cells from malignant parts of the body.The most common forms of metastasis are from lung cancer, breast cancer, skin melanoma and kidney cancer.

In general, a patient with cancer has 15-30% chance to develop brain metastasis. Most commonly, metastatic brain tumors appear in the cerebral hemispheres or in the cerebellum.