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?

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!

Though childhood brain tumor is a rare disease, still, many children of any age all over the world suffer from this condition. Unlike the brain tumors in adults, brain tumors in children is a bit different. Brain tumors are probably the most common form of solid tumors affecting children. However, having knowledge of the symptoms, probable treatment of the disease can help the parents in coping with the situation in a better way and taking the right decision at the right time.

What is a brain tumor?
A group of abnormal cell growth in the brain is referred to as a brain tumor. The types of brain tumor depend upon the structure of the tumor cells, their rate of growth, composition and several other characteristics. However, two most common types of brain tumor affecting children are primary and secondary. In primary brain tumor, the tumor cells develop in the brain, while in secondary, cancerous cells invade the brain from other parts of the body.

Symptoms that determine the presence of tumor may vary in every child. The variation is due to certain aspects including size of the tumor, the location of the tumor, how the tumor is affecting the brain, etc. Some of the most common symptoms of childhood brain tumor are severe headaches, occasional seizures, feeling of sickness and vomiting, eye problems such as blurred visions, feelings of drowsiness without any reason, etc. Some children suffering from brain tumour may also experience difficulty in maintaining balance when walking or behavioral changes in children.

Treatment
While for some, surgical removal of the tumor may be the only treatment solution, for some sessions of radiotherapy and chemotherapy turn out to be really helpful. To control or reduce the effects of the brain tumor symptoms, taking regular medications may also be necessary for the affected children. Doctor may devise the best treatment plan despending on the condition of a child. As the treatment completely depends on the severity of the problem.

Prognosis
Depending on the grade, location, and type of tumor as well as the treatment, the overall health of children can be determined. While a significant number of children often successfully recover from the brain tumor, for some, the treatment needs to be continued for many years. As the nervous system of a child is in its developing stage, sometimes, children may develop some kind of learning or behavioral or physical disability as a result of the brain tumor treatment. If a child has any of these symptoms mentioned above, his or her parents should consult a medical professional right away. The sooner it is diagnosed, the better are the chances for the child to recover from a brain tumor.


Brain Tumor In Children - Understanding It In Detail!

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!

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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