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

Brain tumours vary in shape and size and the same is the case with their symptoms. The location of the tumour affects the symptoms greatly. Just like in any other type of a malignant tumour, brain tumour has a rapid growth and proliferation of abnormal cells that may have its origin in affected site or areas adjacent to it. As per studies, every 2 in 1,00,000 people are said to be affected by brain tumour in India. However, it may come as a relief to some as not all brain tumors are cancerous or life threatening. Some are benign tumors and seldom pose any threat to the affected individual.

Types of Brain Tumor
Brain tumors may be primary or secondary.

Primary brain tumor: Here the abnormal mass of cells that originated in the brain do not metastasize to the other organs. Based on their location in the brain, the primary brain tumors may be of the following types.
Gliomas: One of the most common types of primary brain tumors, gliomas can have their origin in the spinal cord or the brain. Some of the common types of gliomas include Astrocytomas (originates in the cerebrum of the brain), Glioblastomas (these tumors form from the Astrocytes which form the supportive tissues of the brain), Ependymoma (these develop from the ependymal cells which are present within the CNS), Oligodendrogliomas (these tumors are found to arise from the oligodendrocytes).
Schwannomas: Also called as Acoustic neuromas, these primary brain tumors form on the nerves that play an important role in regulating the balance and hearing from the inner ear to the brain.
Meningiomas: These type of tumors are usually benign and have their origin in the meninges (membranes surrounding the spinal cord and the brain).
Primitive neuroectodermal tumors (PNETs): Primitive neuroectodermal tumors (PNETs) are rare malignant tumors that originate from the fetal (embryonic) cells in the brain.
Pituitary adenomas: As the name suggests, these tumors arise from the pituitary gland located at the base of the brain.
Medulloblastomas: Common among the children, these malignant primary tumors develop in the brain (lower back) and gradually spread via the spinal fluid.
Other types of primary brain tumors include Craniopharyngiomas and the Germ cell tumors.
Secondary brain tumors: Unlike the primary brain tumors, these tumors have their origin in the other body parts and organs (mostly in the lungs, skin, colon, breast, and kidney) and then gradually metastasize to the brain. The secondary brain tumors are found to be more common.
Symptoms or warning signs associated with brain tumors:
Some of the signs and symptoms that may be indicative of a brain tumor include

People with brain tumors often get seizures (due to the irritation caused by the tumors in the brain).
A headache (mild to severe depending on the part of the brain affected by the tumor).
A person experiences numbness or a tingling sensation in the legs and arms.
There may be difficulties in walking or balancing.
A person finds it difficult to concentrate.
There may be some problems with hearing, speech or even vision.
A person may experience weakness restricted to only one part of the body.
The symptoms may not necessarily indicate a brain tumor but it is always wise not to neglect the symptoms either.

Brain Tumor - What Are The Types?

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!

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?

A brain tumor can occur at any age and it generally occurs in people in the age group of 40-60 years. The common types of brain tumor are termed as meningioma and gliomas. These supratentorial brain tumors generally occur above the covering of the cerebellum tissue. In children, brain tumors occur at the age of 1-12 years and the most common tumors are ependymomas, astrocytoma and meduloblastomas. Brain tumor is the common cause of death even in children.

Tips to Detecting a Brain Tumor

The general symptoms that are indications of a brain tumor include severe headaches, memory changes, nausea, drowsiness, sleep problems, fatigue and sudden involuntary movements of muscles of an individual. The symptoms can be either specific or generic and the general symptoms are mainly caused by the pressure of the tumor on the brain. The specific symptoms on the other hand are caused when specific parts of the brain does not function properly. Many people even experience loss of control of body functions.

The other problems that are experienced by individuals include changes in the ability to perform daily activities and loss of balance. They find difficulty in hearing, speech and at times are very aggressive. If these symptoms exist, then your doctor would recommend a physical examination and ask about your health history and that of your family.

Tests to Detect Brain Tumor
The tests that are advised by doctors to detect a brain tumor include MRI, neurologic exam, CT scan, biopsy, angiogram and spinal tap.

In the neurologic exam the vision, alertness, hearing, coordination, muscle strength and reflexes are checked by the doctor. The doctor also checks for any swelling in the eyes which can be caused by the pressing of the nerve which connects the brain and the eye.

The CT scan done for detecting brain tumor provides detailed pictures of your head and it is done through an X-ray machine which is connected to a computer. The contrast material is injected into the blood vessel of your hand and abnormal areas can be seen easily.

Biopsy
In this method tissues from the brain are removed and tested for tumor cells. The cells are observed by a pathologist under a microscope mainly to check for abnormal cells. The biopsy method is used to show tissue changes that can further lead to cancer. Brain tumor can be easily diagnosed with this method.

MRI:
Magnetic Resonance Imaging or MRI as it is commonly referred to is of great use as it helps to diagnose brain tumors. In this procedure, a dye is injected through a vein in the arm using which the variances in the tissues of the brain can be identified.

Consult your doctor today for more information on the same.

Tips For Detecting A Brain Tumor!

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

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