Brain Tumor: Symptoms and Treatement

By Dr. K N Krishna, Consultant Neuro Surgeon, Wockhardt Hospitals

What is a Brain Tumor

A brain tumor is a disease in which certain cells of the brain and it’s covering called the meninges grow without any control inside the brain.

Kind of Brain Tumors

There are two main types of brain tumors:

( a) Benign tumors are those tumors which generally grow slowly and do not destroy normal brain tissue. They do not generally regrow after radical surgical removal. They usually do not need radiotherapy.

( b) Malignant tumors are typically called brain cancers. These tumors can grow again after surgical removal. They are very aggressive tumors and difficult to treat them. They are basically of two types

(1)Primary brain cancer originates inside the brain.

(2) Secondary or metastatic brain cancer spreads to the brain from another cancer site in the body like lung cancer and breast cancer. This is again a very difficult tumor to treat and the tumor can regrow after treatment.

Causes of a Brain Tumor

The cause of primary brain cancer is unknown. As mentioned above, secondary brain cancers grow from a cancer elsewhere in the body.

Symptoms of Brain Tumor

The Symptoms are mainly of two types

1.Due to addition of extra mass (tumor and fluid retention) inside the skull which increases the pressure. They may be headache, vomiting, blurring of vision/double vision, vertigo

2.Due to irritation or paralysis of the part of the brain or the nerves coming after the brain resulting in seizure, weakness of one limb or one half of the body, vertigo with imbalance, buzzing sound in the ear with diminished hearing (specially one sided), pain or numbness in one half of the face, difficulty in swallowing, nasal regurgitation, change in voice, repeated aspiration into the lungs.

Diagnosis of a Brain Tumor

The doctor may ask about symptoms and medical history and perform a physical exam, with particular attention to the neurologic exam such as muscle strength, co-ordination, reflexes, response to stimuli and alertness. The doctor will also look into your eyes to check for signs of brain swelling

Diagnostic Tests may include:MRI Scan a test that uses harmless (even to foetus and elderly) magnetic waves to scan the brain and nerves. CT Scan a type of x-ray that uses a computer to make pictures of structures inside the brain.

Treatment For Brain Tumor

The main aim of treatment is not only to prevent further damage to the brain but also recover the functions of the brain by removal of the tumor itself and additionally by using the medication.

Medicines: The doctor prescribes medicines to reduce brain swelling (steroids), seizures (anti epileptic), etc. the latter might have to be taken for longer duration.

Craniotomy and Resection of tumor: Most of the tumor surgeries are done under general anesthesia so that the patient is relaxed and do not suffer from any pain.However in recent times certain brain tumors are removed under local anesthesia where in patient will be awake and talking but not feel the pain , this special procedure is done in such situation where the tumor is growing in close proximity to vital centers like the speech centers ,center for movement etc in the brain.

To access the brain tumor, a portion of the skull bone is delicately cut using high speed pneumatic bone dissector so that it can be replaced and fixed after the surgery. Neurosurgeons operate under high magnification and lighting by using special operating microscope and endoscopes which help in reaching various parts of the brain through narrow gaps safely without damaging the normal brain around the tumor.

In addition operative tools like operative imaging, neuronavigation, etc. help the surgeon in accurately localizing and precisely delineating the tumor from the normal structure and then remove it radically. Special equipments such as CUSA and lasers are sometimes necessary to breakdown deep routed or a difficult tumor.

Usually the patient is kept in the intensive care unit (ICU) on the night of surgery for monitoring his neurological functions closely. Next day morning he is started on oral feeds and shifted to the ward for nursing care He will be given some injections for a few days and subsequently, oral drugs started. Patient will be released from the hospital in 4-5 days and followed up in the clinic.
Stereotactic biopsy: Here, the neurosurgeon uses a MRI /CT scan images of the brain to delineate the tumor.

By using a special stereotaxy frame or Computor assisted Neuro Navigation system the tumor site is localized to an accuracy of 1mm. Thena small needle is pushed in to the tumor through the hole and a sample of tumor tissue is obtained. This tissue is sent for pathological tests to identify the tumor. This type of surgery is done for tumors located deep inside the brain or near critical areas. Depending on the pathological tests, further treatment is recommended.

How difficult is it to Treat Brain Tumor.

With advances in brain tumor surgery management, most patients with benign tumors have normal lives. Brain cancer patients have a shorter period of survival and longevity, depending on the type and location of the tumor. With early diagnosis and microsurgical medical tumor removal followed by chemotherapy and radiotherapy, patients even with tumors have led almost a normal life for few years. Therefore, do not overlook a headache or any other symptom of brain tumor.

DR (Prof). K.N.Krishna
M.Ch (Neuro Surgery).
Chief Consultant Neuro Surgeon
Wockhardt Hospitals,Bangalore

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