This is doctor Nitin Jagdhane. I am a consultant neurosurgeon, brain and spine surgeon. Today we are going to discuss about brain tumors, to start with what exactly causes Brain tumor actually scientists have not found any exact reason as of now that what causes brain tumors, but some patients usually children if they get some radiation dose during their childhood, excessive radiations, they may have brain tumors. Some tumors are caused by hereditary inheritance like neurofibromatosis which run in families and many people more than 65 years of age, they get kind of brain cancer which is called as Glioma, so the reasons for such cancers are usually not known, but they usually affect people who are elderly, more than 60-65 years of age. So to start to know what are the types of brain tumor, basically as anywhere in the body there are two types of brain tumors. Few tumors are called as benign brain tumors, benign means which are not harmful and the other type is a malignant brain tumor or cancer what we can call it as. All the burning brain tumors are not harmful as such by definition, but if they are in a part of the brain which is critical or the part of brain which is controlling the left side of the body or left side of the brain rather are more difficult to exercise and sometimes carry equal or even more risk than the so called malignant brain tumors.
These are the primary brain tumors which we discussed but there are some Brain tumors which are secondary also, like if there is anywhere cancer or tumor inside the body and that may also spread to the brain which are called secondary brain tumors, so depending on the part of the brain involved these tumors can be either in the larger part of the brain which is called cerebral hemisphere or the supratentorial what we call it and there are few tumors which affect the small brain or the cerebellum or the posterior fossa tumor or the infratentorial part of the brain, so usually the location that can also be divided based on the surface location of the tumor like which lobe of the brain they are involved like frontal lobe, parietal lobe on the sides, then posteriorly in the occipital lobe or maybe in the subtentorial region like in posterior fossa involving the cerebellum or the brain stem. They can be classified whether they are skull base that is affecting the part of the brain which is very close to the base of the skull which are more difficult to exercise. Now to come to the usual symptoms of brain tumors. Usually the patients of Brain tumor are present with excessive headache especially in the morning, whenever they get up in the morning they get headache associated with vomiting, sometimes we call it projectile vomiting.
Projectile vomiting means vomiting which is not preceded by the nauseating symptoms usually which many people have it. 2nd symptoms are, along with the headache patients find blurring of vision, some patients may even get convergence or we call it as seizures or fits, some people also present with paralysis of any side of the body, paralysis of the face or what we call as facial paralysis or maybe hemiplegia which affects either part of the body. Some patients if they have tumors in the frontal part of the brain or in front part of the brain they even present with behavioral disturbances, some patients which have benign brain tumors like which are not malignant but they grow into a very big size and then they create a Mass effect which affects the entire brain and which causes a rise in intracranial pressure, so such patients can sometimes directly come with unconscious state also because of the rise in intracranial pressure, so any of the symptoms if any of your relative and you find in someone you have to consult a neuro specialist so that they can guide you further regarding what can be done in such cases. So usually whenever anyone gets such kind of symptoms you have to see a neuroscientist, either a neuro physician or a neurosurgeon, neurosurgeons are better because they operate these kind of tumors and once you go to a neurosurgeon he will usually evaluate with either a CT scan or maybe MRI scan of the brain and based on the MRI scan or CT Scan findings he will discuss with you what kind of tumor it is, whether it is a benign tumor or whether it is a brain cancer and based on that the next line of treatment is usually devised.
So the usual line of treatment for any kind of Brain tumor is surgery unfortunately because none of the brain tumors can be cured with medicines alone and even if there are some tumors or tumor-like lesions like sometimes tuberculosis also can present with some lesions which sometimes are very similar to brain tumors, but whatever is the case the neurosurgeon has to find what it is exactly and to find what it is exactly, we have to do the surgery. The surgery can vary from minimally invasive right from the stereotactic biopsy what we call it by just putting a hole in the skull bone and putting needle through it and taking a piece of the tumor and then sending it for histopathological examination and based on that we take further decisions, but many a times surgery is contemplated for such cases. Surgery for brain tumors is basically based on the nature of the tumor rather than anything, like the location of the tumor where is it? is it in the areas which are easily accessible or whether it is close to the areas which are very important part of the brain, so in such places sometimes it is difficult to excise or to remove the tumor completely, even if it is a benign tumor or even if it is a malignant tumor, so as I said earlier that even if the tumor is benign or not malignant or it is just a simple tumor it also can be dangerous depending on its location so the usual surgery which is done is either complete surgical removal, if it is accessible either a partial removal in which part of the tumor is excised and remaining part is left behind that is we called as the maximum safe resection of the tumor and many a times if the tumor is very deeply located or situated in the part of the brain which is very delicate or where tumor cannot be reached in such cases most of the times the stereotactic biopsy option is used, in which the exact location of the tumor is navigated through the computer program and based on that only a single hole is made and needle is past and the part of the tumor is taken out and send it for the biopsy.
The usual procedure which is done for either partial or complete removal of the tumors is by doing the craniotomy. Craniotomy means opening up a part of the skull, the skull bone which is drilled and which is cut out and the brain is accessed and through that access we usually reach the brain tumor we take it out and send it for histopathological examination and then close it with sutures. Many a times we replace it with bone flap and fix it with sutures or maybe the screws and plates and then suture the skin and the fascia above that or the skull with regular sutures or maybe staplers, so that is the routine commonly done operation called craniotomy. So based on the patient’s condition. Patients are directly shifted to ICU or maybe if they are good enough, their tumor was accessible and easily taken out, sometimes they are shifted to the wards, so during 7 days time we get histopathological examination and based on this the further course of action is devised.
If the patient has a benign tumor and if it is completely excised then no more treatment is usually required just a follow up every 6 months or maybe yearly is sufficient but if the tumor is malignant one like Glioma or grade IV glioblastoma multiforme, which is usually seen in patients who are 65 years and more so in cases where the tumor is a malignant tumor like a glioblastoma multiforme usually seen in people of more than 65 years of age, such patients they require additional forms of treatment like chemotherapy and/or radiotherapy sessions. So based on this histopathological examination the treatment is given and the neurosurgeon will be able to tell you based on the histopathological diagnosis that what is the prognosis in such kind of tumors and what kind of humour it is and what kind of case we are dealing with. So this was in short about the brain tumors whenever you have any patient who has got these kinds of symptoms like as I told you earlier, you can visit your neurosurgeon and he will further guide you regarding the best possible treatment for your patient, thank you. So this was in short about brain tumors if you would like to go through any of the other videos regarding any neurosurgical problems you can login to the lybrate.com and go through the rest of the available videos.