June is known as the Brain Tumour Month worldwide. It s worthwhile to raise public awareness and educate people about brain tumour, a disease which, though is rare is but can be really deadly. More than 500 new cases are diagnosed with brain tumour every day worldwide. The number of patients with secondary tumours are even higher than 500. However, it is common across all ages.  A primary brain tumour is a tumour that begins in the brain. It can be either malignant, which means it contains cancer cells or benign i.e. does not contain cancer cells. A secondary or metastatic brain tumour is usually cancerous. It starts elsewhere in the body and sends cancerous cells which grow in the brain.

Here are a few facts that each one of us should know about this dangerous disease

Brain tumours can occur at any age.
We don t know what causes brain tumors. Family history and high dose radiation like X-rays increases your risk.
Doctors group brain tumors by grade which means the way the brain cells look under a microscope. A higher grade number means the cells appear more abnormal and the more aggressively the tumour usually behaves.
Brain tumors are graded as grade I, grade II, or grade III, or grade IV.
Symptoms
The symptoms of brain tumour depend on the size, type, and location of the brain tumour. Some common symptoms which should not be ignored are-

Headaches
Seizures
Problems with vision
Vomiting
Mental and personality changes
Balance problems and trouble walking
Problems in speaking
Diagnosis
Brain tumours are diagnosed by the doctor based on the medical history and physical examination along with a slew of specialized tests of the brain and nervous system.

Treatment

Surgery
Radiation therapy
Chemotherapy
Anti-seizure medicines
Steroids
Ventricular peritoneal shunt
Combination of treatments
How can you safeguard yourself?
The primary tool to prevent brain tumours is by controlling your lifestyle. This means eating healthy, exercising, avoiding known carcinogens in your environment, and reducing stress.

Sleep: Sleep is a friend for brain health. An adequate amount of rest with eyes shut keeps your brain health.
Frankincense oil: Along with yoga, meditation, and breathing exercises to reduce stress, inhaling frankincense oil can help alleviate inflammation in the brain.
Anti cancer diet: Consuming a diet rich in cancer-fighting nutrients like antioxidants is critical in preventing brain tumors.
Ketogenic diet: A ketogenic diet is a high protein diet. It reduces oxidative stress and inflammation in the brain which is associated with brain tumours. It also shuts down the nutrient supply to tumors.
Calorie restriction: Dietary restriction, especially fasting has anti-carcinogenic properties just as the ketogenic diet.
Limit exposure to mobile phones: Cell phones use increases risk for brain tumours. So restriction prevents these tumours.

World Brain Tumor Day - 6 Tips To Help You Prevent Yourself Against It!

A brain stroke can affect anyone at any point of time when the supply of blood to the brain is interrupted. It can threaten major physical functions and can prove to be fatally dangerous at times. The brain stem which is placed right above the spinal cord controls the breathing, heartbeat and levels of blood pressure. It is also in charge of controlling some elementary functions such as swallowing, hearing, speech and eye movements. 

What are the different types of strokes?
There are three main kinds of stroke: ischemic strokes, hemorrhagic strokes and transient ischemic attacks. The most common type of brain stroke is the ischemic stroke is caused by narrowing or blocking of arteries to the brain, which prevents the proper supply of blood to the brain. Sometimes it so happens that the blood clot that has formed elsewhere in the body have travelled via the blood vessels and has been trapped in the blood vessel which provides blood to the brain. When the supply of blood to a part of the brain is hindered, the tissue in that area dies off owing to lack of oxygen. The other variant of brain stroke is termed as hemorrhagic stroke is caused when the blood vessels in and around the brain burst or leak. Strokes need to be diagnosed and treated as quickly as possible in order to minimize brain damage.  Remembering the F.A.S.T. acronym can help with recognizing the onset of stroke (Face, Arms, Speed, Time - explained below). 

What are the common symptoms of a brain stroke?
The symptoms of the brain stroke are largely dependent on the area of the brain that has been affected. It can interfere with normal functioning, such as breathing and talking and other functions which human beings can perform without thinking such as eye movements or swallowing. Since all the signals from the brain as well as other parts of the body traverse through the brain stem, the interruption of blood flow often leads to numbness or paralysis in different parts of the body.

Who is likely to have a stroke?
Anyone is at a risk of developing brain stroke although ageing is directly proportional to the risk of having a stroke. Not only that an individual with a family history of brain stroke or transient ischemic attack is at a higher risk of developing stroke. People who have aged over 65 accounts for about 33 percent of all brain strokes. It is important to point here that individuals with high blood pressure, high blood sugar, cholesterol, cancer, autoimmune diseases and some blood disorders are at a higher risk of developing brain stroke.

There are a few factors which can increase the risk of developing stroke beyond any control. But there are certain lifestyle choices as well which aids in controlling the chances of being affected by stroke. It is crucial to refrain from long-term hormone replacement therapies as well as birth control pills, smoking, lack of physical activity, excessive use of alcohol and drug addiction. A brain stroke is a life-threatening medical condition, and when an individual has symptoms that resemble that of stroke, it is crucial to seek immediate medical help.

Treatment for stroke

Treatment depends on the type of stroke.
Ischemic strokes can be treated with 'clot-busting' drugs.
Hemorrhagic strokes can be treated with surgery to repair or block blood vessel weaknesses.
The most effective way to prevent strokes is through maintaining a healthy lifestyle.
What is TPA?
TPA is a thrombolytic or a  Clot Buster  drug. This clot buster is used to break-up the clot that is causing a blockage or disruption in the flow of blood to the brain and helps restore the blood flow to the area of the brain. It is given by intravenous (IV). This can be given only within 4.5 hrs of the onset of symptoms

Time is brain

Remember Every second Loss means brain cells die.
Rush to the nearest Stroke Centre whenever you experience such symptoms.
U can save the brain cells dying if you reach within 4.5 hrs by the CLOT BUSTER. 
Endovascular procedures 
Another treatment option is an endovascular procedure* called mechanical thrombectomy, strongly recommended, in which trained doctors try  removing a large blood clot by sending a wired-caged device called a stent retriever, to the site of the blocked blood vessel in the brain

Stroke prevention
The good news is that 80 percent of all strokes are preventable. It starts with managing key risk factors, including 

High blood pressure,
Cigarette smoking,
Diabetes
Atrial fibrillation and
Physical inactivity.
More than half of all strokes are caused by uncontrolled hypertension or high blood pressure, making it the most important risk factor to control. 
Rehabilitation
The best way to get better after a stroke is to start stroke rehabilitation ("rehab"). In stroke rehab, a team of health professionals works with you to regain skills you lost as the result of a stroke.

Brain Stroke - Things You Must Know!

A tumor is an uncontrolled and abnormal growth of cells. A brain tumor is thus an abnormal growth and multiplication of cells in the brain. The cell growth can also be in areas adjacent to the brain. The brain tumor may

Have its origin in the brain (Primary brain tumor), or
Its origin may be in some other parts or organs of the body, which gradually spreads to the brain (Secondary/metastatic brain tumor).
Not all brain tumors are harmful and life threatening.

Brain tumors that exist as noncancerous cell growths are known as Benign brain tumors. Benign brain tumors seldom pose any threat to life.

Brain tumors that are cancerous and, thus, harmful, are known as Malignant brain tumors.

Do not neglect any brain tumors (malignant or not). It is better to be safe than to be sorry.

Types of Primary brain tumors:

Based on its cell of origin, primary brain tumors (benign as well as malignant) may be of the following types:

Meningiomas: Brain tumors that originate from the meninges (the membranes that cover the brain and the spinal cord). Meningiomas are seldom malignant.
Acoustic Neuromas: A noncancerous cell growth that has its origin in the vestibulocochlear nerve (the eighth cranial nerve). This nerve connects the brain with the inner ear.
Gliomas: Here, the tumor has its origin in the brain and the spinal cord (glial cells). This type of brain tumors, in most cases (~80%), are malignant.
Primitive Neuroectodermal Tumors (PNETs): Extremely rare, PNETs are malignant tumors that develop in the embryonic cells in the brain.
Medulloblastomas: Medulloblastomas is a malignant brain tumor that mostly affects children. It originates in the cerebellum (lower part of the brain).
Craniopharyngiomas: A benign brain tumor that has its origin near the pituitary gland (base of the brain). Craniopharyngiomas are common in children.
Probability of a secondary brain tumor are more in people who have had;

Kidney cancer
Breast cancer
Lung cancer
Colon cancer
Melanoma
Symptoms:

The symptoms of brain tumor include:

Chronic and regular headaches.
A change in the headache pattern.
Seizures.
A person may experience vision problems (Peripheral vision may be affected, double or blurred vision).
There may be difficulty in hearing.
Nausea and vomiting.
Behavioral and speech problems.
An arm or a leg may lose sensation.
A person has difficulty with balance.
Diagnosis and Treatment:
Though brain tumor can affect anyone and everyone, its chances are higher in

People who are more exposed to ionizing radiation. People having undergone a radiation therapy are equally vulnerable.
Children as well as older people.
People having a family history of brain tumors.
The diagnosis includes;

An imaging test like the MRI, CT scan and PET (Positron Emission Tomography).
Biopsy, whereby samples of the abnormal tissue is collected and examined.
Neurological examination.
Treatment:

Surgery is an effective treatment for brain tumors.
One can also opt for:

Radiations, whereby the abnormal tumor cells are destroyed using protons and x-rays (high-energy beams).
Chemotherapy: In this treatment, the tumor cells are destroyed using strong drugs (taken orally or intravenously).
Radiosurgery.
Targeted drug therapy: This treatment blocks the abnormalities that are characteristically present only in the cancer cells.

Brain Tumors: Types, Symptoms, Diagnosis, and Treatment

There is no trustworthy evidence regarding what causes brain tumors, but there are a few risk factors that have been substantiated through research. Children and young people who receive radiation around the head are susceptible to developing tumors in the brain once they grow up. Also, people with a certain kind of rare genetic condition like neurofibromatosis may develop a brain tumor though such cases are very few in number. Age is also an important factor as people aged over 65 years are diagnosed with brain tumors at quadruple times higher than children and younger people.

Types of Brain Tumours-

A primary brain tumor originates in the brain, and they may or may not be cancerous. Some tumors can be benign, which do not spread in the surrounding tissues and are not very malicious. However, that does not signify that they will not cause any harm over time. Sometimes these tumors can be severe and cause a threat to the life of the sufferer. The National Cancer Institute reports that approximately there were 23, 380 fresh cases of brain tumors in 2014.

Identifying the Symptoms of Brain Tumors...

The symptoms of the brain tumor are dependent on various factors such as the size, type as well as the exact location of the tumor. These symptoms are triggered when any tumor is pressed or clashed against a nerve or disturbs a part of the brain. Symptoms are also felt when any tumor particle blocks the fluid flowing around the brain or when there is a swelling in the brain owing to the build-up of fluid.

Common symptoms include- headaches that get worse in the morning, nausea along with vomiting, an alteration in the speech, hearing and imbalances in walking and movement, mood swings, change in personality and ability to concentrate or remember things and seizures or convulsions.

Treatment for Brain Tumor-

Surgery is normally the most usual treatment for brain tumors, and the patient is given anaesthesia, and the scalp is shaved before the surgery. Then, craniotomy is performed to open the skull, and the surgeon removes a bone piece out of the skull. Then the tumor is removed as much as possible. The bone is then restored back, and the incision on the scalp is closed. Sometimes surgery is not viable in case the tumor has developed in the brain stem or some other complex parts.

Neurosurgeons can surgically remove some tumors completely (called resection or complete removal). If the tumor is near sensitive areas of the brain, neurosurgeons will only be able to remove part of it (called partial removal). Even partial removals can relieve symptoms and facilitate or increase the effectiveness of other treatments.

The role of surgery in treating brain tumors

Surgery can provide:

- The complete removal of some brain tumors
- A sample to enable doctors to diagnosis the tumor and recommend the most appropriate treatment
- Better quality of life:
- Reduced symptoms and improved ability to function (e.g., to think, speak or see better)
- Less pressure within the skull from the tumor
- A longer life

In case you or any of your near ones is affected with brain tumor, you should visit the doctor to know the possible treatments other than surgery and other important questions related to brain tumor.

Brain Tumor - Causes, Symptoms and Treatment

Although surgery is considered to be the first step of treatment in any form of tumor, but its feasibility depends upon the type, size and location of the tumor. It is not necessary that every kind of brain tumor might require surgery.

Indications of Brain Tumor Surgery
- Diagnosis of the type of tumor by taking a sample of the tumor for laboratory examination
- Complete resection of tumor
- Removal of the tumor as much as possible to slow down its growth and improve the symptoms
- Remove the tumor in order to help other treatment
- Provide direct access for other forms of treatment like chemotherapy, radiotherapy etc.
- To relieve pressure caused by tumor on surrounding structures

Types of Brain Tumor Surgery
The different types of surgery that are performed in cases of brain tumor include the following:

Craniotomy: Craniotomy is the most commonly performed procedure to remove brain tumor along with a piece of bone. The removed bone is replaced and the tumor is sent for histopathology (biopsy). The surgery is performed using a high end microscope by any of the following techniques:
- Extended bifrontal craniotomy
- "Eyebrow" craniotomy (supraorbital craniotomy)
- "Keyhole" craniotomy (retro-sigmoid craniotomy)
- Orbitozygomatic craniotomy
- Translabyrinthine craniotomy

Shunt: A narrow piece of flexible tube with a pressure regulated valve in between is called a shunt. This is used to relieve the intracranial pressure caused by obstruction of the natural brain fluid, Cerebrospinal fluid (CSF) pathway by tumor mass. The procedure involves insertion of a drainage system into the brain to remove or drain excess of blocked fluid into the peritoneal cavity.

Stereotactic surgery: This surgery is done by creating a three dimensional image called stereotaxy using computers. It aims to find out the location and position of the tumor. In fact it can also be done to aid tumor removal, implant radiation pellets or for other treatments.

Embolization: It is a procedure used to reduce the amount of blood supply to a tumor by blocking the blood flow in the selected arteries. It is generally performed before the main surgery.

Endoscopy and endoscope assisted surgery: Endoscope is a tool, which helps to closely visualize the tissue through small openings in difficult to reach areas. This tool can be used in various brain surgeries to precisely reach the target location without damaging the adjacent structures.

Adjuvant modalities to improve outcome: In addition to above mentioned surgeries, following surgeries may also be performed in relation to brain tumor treatment:
- Laser surgery
- Photodynamic laser surgery
- Ultrasonic aspiration
- Fluorescence guided surgery (FGS)
- Electrophysiological monitoring

Brain Tumor Surgery

Grading of brain cancer is entirely different as compared to the staging of other cancers in the body. Cancer in the breast, lung, colon etc. are staged depending on the possible spread, location of a tumor and lymph node involvement etc. However, brain tumors are graded based on the aggressiveness of the tumor cells under a microscope. The resect ability and the grade of the tumor cells guide a doctor on the treatment decisions. The decision of a brain surgery depends on factors such as the location, spread of a tumour and the general health of the patient.

Types of Brain Tumor Grading:

Grade 1 tumor- These sets of tumors are medically known as the juvenile pilocytic astrocytoma and subependymoma. They are slow growing and non-invasive. There is a likelihood of the patient getting cured with surgery.
Grade 2 tumor- These are brain tumors that do not possess dead cells as part of the tumour. But, they do portray a lot of abnormal cells. Tumors of this type can be categorized under oligodendroglioma, astrocytoma, and ependymoma.
Grade 3 tumor- Tumors of this type are graded based on the cell type of the cancer cells. For instance, an anaplastic astrocytoma is a grade 3 tumor that has no dead cells but possesses dividing cells. In contrast, anaplastic ependymoma and anaplastic oligodendroglioma are grade 3 tumor cells that have dead cells in them.
Grade 4 tumor- Tumors of this type are referred to as glioblastoma. The tumor cells are actively dividing, the growth of blood vessels is witnessed and areas of dead tissue keep expanding.

Treatment options:
Surgery- If the location of a brain tumor is such that it is accessible to a surgeon, the latter goes ahead and removes most of the tumor if not the whole. If, however, the brain tumor cells are placed very near to the surrounding very sensitive brain tissues, a doctor might remove a small portion of the tumor to curb its growth.
Radiation Therapy- This mode of treatment uses high energy X-ray beams to kill targeted cells of the brain. External beam radiation usually targets a small area of the brain. A whole brain radiation, on the other hand, is usually employed when a tumor has spread to most parts of the brain. Radiotherapy is now so evolved that it is highly targeted to tutor cells that kills cancer and spares normal brain .
Chemotherapy- Chemotherapy employs drugs to kill cancer cells. Chemotherapy can either be taken in the form of an IV or in the form of pills. The dosage of chemotherapy is decided based on the concentration of cancer cells, spread frequency, platelet count of the patient etc. The most common chemotherapy drug that is prescribed by doctors to fight cancer cells is temozolomide.

Brain Tumor - Stages and Treatment!

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