Brain cancer is a disease of the brain in which cancer cells (malignant cells) arise in the brain tissue. Cancer cells grow to form a mass of cancer tissue (tumor) that interferes with brain functions such as muscle control, sensation, memory, and other normal body functions. Tumors composed of cancer cells are called malignant tumors, and those composed of mainly non-cancerous cells are called benign tumors. Cancer cells that develop from brain tissue are called primary brain tumors while tumors that spread from other body sites to the brain are termed metastatic or secondary brain tumors.

Prologue:

Brain cancer is actually the abnormal growth and uncontrolled growth of the cancer cells in the brain,that forms a tumor in the brain.Tumours can be either benign or malignant.

Benign brain tumours are abnormal collections of cells that reproduce slowly and usually remain separate from the surrounding normal brain.

Malignant tumours reproduce and grow quickly. Their borders are hard to distinguish from the normal brain around them.

Symptoms:

There are few early symptoms of brain cancer, but as the tumour grows within the confines of the skull, it causes increased intracranial pressure and exerts pressure on the brain, causing signs to develop.

Brain cancer symptoms and signs are varied and depend on the area of the brain involved, but can include:

Headaches.

Seizures.

Nausea and vomiting, which, CANSA reports, may be worse in the morning or after a sudden position change.

Difficulty walking or clumsiness.

Vision changes.

Changes in alertness.

Behavioural impairment.

Causes:

Brain cancer occurs when there is an uncontrolled growth of cancer cells in the brain that form a malignant brain tumor. The underlying cause of primary brain cancer, cancer that begins in the brain, is not known. Secondary brain cancer is caused by a cancer of another organ in the body, such as the breast, prostate, kidney, skin, or bone, that has spread to the brain.

What are the risk factors for brain cancer?

Certain inherited conditions, including neurofibromatosis, Von Hippel-Lindau syndrome, Li-Fraumeni syndrome, and Turcot syndrome

Personal history of cancer or family history of brain cancer

Impaired immune system

Radiation therapy of the head

Treatments Options:

Treatment

Surgery is the main form of treatment for brain tumors that lie within the membranes covering the brain or in parts of the brain that can be removed without damaging critical neurological functions. The goal is to remove the entire tumor, whenever possible, as a tumor may recur if any tumor cells are left behind. Radiation therapy and chemotherapy are generally used as secondary treatment for tumors that cannot be cured through surgery alone.

Stereotactic radiosurgery

Stereotactic radiosurgery is a treatment option that delivers a high concentration of radiation directly to the tumor in order to stop its growth, while delivering only a minimal dose of radiation to the surrounding tissue. Unlike conventional surgery, stereotactic radiosurgery does not require making an incision to remove the tumor. It can be especially effective in patients with many small metastatic brain tumors.

Brain Cancer

The most powerful and amazing organ in our body is the brain. It differs from many other organs of our body not only by its shape, but also by its special type of cell called neurons. When these cells gets affected or dead it can never be reverted or regenerated which is the most exclusive nature found only in brain cells. The cells in other parts of our body has the capacity to regenerate (can be replaced or new one can be grown or produced), but brain cells are exception. Hence any damage to the brain, injury or trauma is really a crucial thing to be considered with utmost care.

Brain surgeries really need skill, proper training, confidence and intelligence to perform this highly complicated and risky surgery.

Purpose:
Brain surgeries are performed to:

Remove the brain tissues that are grown abnormally
Aneurysm is clipped to prevent flow of blood cliff off an aneurysm
Biopsy purpose or to remove the tumour
Make a nerve free
Drain the abnormal blood or clot collection or to drain any excessive fluid collection caused by infection.
To implant artificial electronic device as a treatment for conditions like Parkinson's disease
Types:

Biopsy: A part of brain tissue is removed for the brain or whole tumour is removed.
Craniotomy: The skull bone is opened to remove tumour, an aneurysm and drain fluid or blood from infection.
Minimally invasive endonasal endoscopic surgery: Endoscopic devices are inserted through the nose to remove the lesions or tumour.
Minimally invasive neuroendoscopy: Similar to endonasal surgery but small incision is made.
Risks:

Anaesthesia risks like breathing difficulty, allergic reaction to medications, excessive bleeding or clots and infection.
Risk related to the brain surgeries are seizures, coma, swelling of brain, infection to brain or meanings, surgical wound infection that intrudes to the brain structures, abnormal clot formation and bleeding.
General risks include muscle weakness, disturbances in memory, speech, vision, coordination, balance and other functions that are controlled by the brain.

Brain Surgery - Know The Purpose Behind It!

A stroke, also called cerebrovascular accident (CVA), cerebrovascular insult(CVI), or brain attack, occurs when a part of the brain is deprived of blood flow. When the brain cells are deprived of oxygen they begin to die. When brain cells die, the functions controlled by that part of the brain also stops, which results in different types of disabilities among stroke survivors.

There are two types of strokes

Hemorrhagic
Ischemic stroke
The first is caused when a brain aneurysm or a weak blood vessel bursts. Most of the time, this type of stroke leads to death. The second one happens when a clot blocks the flow of blood to the brain. Patients suffering from stroke suffer from various side-effects, the most common ones being paralysis or loss of feeling in a certain part of the body, problem in understanding or talking and loss of vision in one side. The side-effects start showing up regularly after a person has had a stroke.

In certain conditions, blood flow to a certain part of the brain stops for only some time and hence the body suffers stroke like symptoms which only last a couple of hours before disappearing. This is known as a transient ischemic attack (TIA). Unfortunately, the effects of a stroke can be debilitating and also permanent. Hence its important to know the symptoms of a stroke and rush the patient to a doctor as soon as possible. Sometimes early treatment can save a lot of damage.

The primary symptoms of stroke are as follows:

Confusion and problems with talking and comprehension
Headache along with alteration of consciousness or vomiting
Numbness of the face, arms or legs, especially on one side of the body
Issue with seeing, in one or both eyes
Inability to walk with stability, including disrupted coordination
Problems with the bladder and bowel control
Acute depression
Body temperature fluctuates, and pain worsens with movement
Paralysis on one side of the body along with fatigue
Problem in expressing or controlling emotions
Risk Factors:

Hypertension
Diabetes
Increased Cholesterol
Smoking
Obesity
Sedentary Lifestyle
Diagnosis of stroke

Several tests are carried out to determine the type of stroke acquired. They are:

Physical examination, which involves observing the patient's overall condition.
Blood tests
CT scans
MRI scans
Cerebral angiogram
Echocardiograms
Stroke is a fatal brain disease and can cause permanent damage to your system so its best to check with your doctor to know how you can prevent it.

Brain Stroke - Factors That Can Lead To It!

If you have noticed your child to be restless and anxious all the time, it might look cute as the child is highly energetic, but it could be a cause for concern at the same time. It is not normal and the child could be having ADHD that is attention deficit hyperactivity disorder. As the name suggests, it is a disorder with deficiency of attention and in which the child is always hyperactive.

ADHD is a disorder in which the symptoms usually show up before the age of seven. It is characterized by a group of behavioral symptoms that include inattentiveness, hyperactivity and impulsiveness. The impact of these symptoms is felt extensively where his overall self-esteem is affected, be it at home, preschool or school, academics or extracurricular activities and in interpersonal relationships.

The most common symptoms, which are almost diagnostic of ADHD are:

Inability to hold attention: The child's attention span is very short and it is very difficult to keep them engaged on one particular thing.
Increased restlessness: The child would be extremely restless and gets distracted easily.
Fidgeting: The child would be seen constantly fidgeting with his fingers.
The following are the less common ones:

Learning disability is rare, but can happen. However, the good news is that it does not affect the child's intelligence.
Sleep disorders
Difficulty in following directions
Poor executive functioning skills
Disorganization, which can lead to poor motor coordination and impaired movements
ADHD kids tend to forget things very easily and need help with coordinating movements
The child suffering from ADHD could easily tire and/or feel lethargic with very low energy levels. This can lead to the child procrastinating things and not wanting to do things on priority basis
These children also have difficulties with fine motor and cognitive skills and so there is delay in their overall participation in games.
While these are the pressing symptoms of ADHD, occupational therapy can play a significant role in managing the child in the following ways. As a first step, the caregiver should have a detailed discussion with the school staff and any other people with whom the child interacts significantly.

This will help identify areas that need support from an Occupational Therapy, which are the following:

Support with gross and/or fine motor skills
Support with improving handwriting
Support with engaging in playing sports and games
Support in engaging in social activities
Improving sensory processing difficulties
Improving visual perception
Support in adapting to the environment
Teaching strategies to participate in various social and academic activities
So, while an ADHD child is definitely a cause for concern, proper support from family can help manage the condition.

ADHD - Know The Symptoms

Brain surgery involves several medical procedures, which incorporate fixing issues with the brain, including changes in the tissues of the brain, cerebrospinal fluid and brain blood flow. Brain surgery is quite a complicated method of surgery and the type of surgery to be conducted depends on the underlying conditions.

Reasons for Brain Surgery:
Brain surgery is performed for the correction of physical brain abnormalities. These abnormalities could occur because of diseases, birth defects and injuries. A brain surgery is required when the following conditions arise in the brain:

Abnormal blood vessels
Aneurysm
Bleeding
Blood clots in the brain
When the protective tissue or dura is damaged
Epilepsy
Due to nerve damage
Parkinson's disease
Any kind of pressure after an injury
Abscesses
Skull fractures
In case of stroke and tumors
A surgery may not be required for all the above mentioned conditions, but in case of many, a brain surgery is very important as the conditions may worsen health problems.

Types of brain surgeries:

Craniotomy: During this open brain surgery, an incision is made in the scalp, and a hole is created in the skull, near the area, which is being treated. After this process is complete, the hole or bone flap is secured in its place using plates or wires.
Biopsy: This form of brain surgery helps in the removal of a small amount of brain tissues or tumors. After removal, the tissues or tumors are examined under a microscope. The creation of a small incision and a hole in the skull is indicated as a part of this process.
Minimally invasive endonasal endoscopic surgery: This form of brain surgery enables the removal or lesions and tumors via the nose and sinuses. Private parts of the brain can be accessed without creating an incision. An endoscope is utilized in the process which is used to examine tumors all across the brain.
Minimally Invasive neuroendoscopy: This process is similar to the minimally invasive endonasal endoscopic surgery. This method also involves the use of an endoscope for removal of brain tumors. Small, dime sized holes may be made in the skull to access some brain parts.
Risks:
Brain surgeries may be associated with several risks. They may be:

Allergic reactions to anesthesia
Bleeding
Blood clot formations
Swelling of the brain
A state of coma
Impairment in speech, coordination and vision.
Problems in memory
Strokes and seizures
Infections in the brain
A brain surgery is a serious and very complex surgery. There are different kinds of brain surgeries, which are conducted depending on the condition and severity of the disease.

Brain Surgery - When It Is Required?

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

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