Brain Tumor

What is a brain tumor

A brain tumor is an abnormal growth of cells in or adjacent to your brain. Brain tumors can arise from the brain cells themselves (primary) or from non-brain cells (secondary). It can be malignant (cancerous) with the high tendency to invade the brain rapidly and aggressively; or benign (noncancerous) usually slowly growing and easily separated from the brain. Only about one-third of brain tumors are malignant.

Some types of brain tumors can also be associated with lesions in your spinal cord.

 

Symptoms

Brain tumors — whether malignant or not — can present wide range of symptoms and in many cases can cause serious problems. This depends on the size and location of the tumor and its effect on nearby functional centers of the brain. Signs and symptoms may include:

• Headaches
• Seizures
• Difficulty thinking, speaking or understanding language
• Personality changes
• Weakness or paralysisin one part or one side of your body
• Balance problemsor dizziness
• Visionproblems
• Changes in hearing
• Facial weakness, numbnessor tingling
• Nausea or vomiting
• Confusion and disorientation
• Memory disturbances

 

Brain tumors can cause problems by

• Destroying or putting pressure on healthy brain tissue
• Increasing pressure within your skull (intracranial pressure)
• Causing fluid to build up in your brain
• Blocking the normal flow of cerebrospinal fluid (CSF) leading to hydrocephalus
• Leading to bleeding in your brain

However, some people have brain tumors that never cause symptoms; others can grow very slowly, in a manner that allows the brain to accommodate the gradual building pressure. Which may postpone the symptoms and therefore delay diagnosis.

 

Diagnosis and Investigations

If you’re experiencing any symptoms of a brain tumor, your healthcare provider should start by taking a detailed medical history of your complaints and then perform a thorough physical and neurological examination which involves looking for changes in your: balance and coordination, power, mental status, hearing, vision, reflexes.

• Brain MRIor CT scan: Magnetic resonance imaging (MRI) is the best imaging modality for identifying and diagnosing brain tumors. Computed tomography (CT) is a possible alternative if you’re unable to undergo an MRI. Injection of contrast material is essential in differentiating between brain tumors and to show the exact tumor’s size and position in detail.
• Visual and hormonal assessment are essential invitations in some brain tumors.
• Spinal tap (lumbar puncture): taking sample of the cerebrospinal fluid (CSF) from around your spine to be tested for cancer cells, is helpful in some cases.
• Specialized tests: such as blood and cerebrospinal fluid for substances that certain tumors release called tumor markers, and test for gene abnormalities that are characteristic of certain tumors.
• Biopsy: taking a sample of the tumor for examination under the microscope using a navigation guidance or stereotactic technique can identify the type of tumor. A neurosurgeonmay perform a biopsy under awake or full anaesthesia surgery.

 

Management and Treatment

Choosing the best treatment option for brain tumor depends on several factors, including: tumor location and its relation to important functional areas of the brain, size and type of the tumor and your age and overall health status.

Benign (noncancerous) brain tumors, if surgically removed, usually don’t grow back. Regarding malignant tumors, treatment may include different modalities:

• Brain surgery(craniotomy): When possible, neurosurgeons remove as much as possible from the tumor. They work very carefully, sometimes performing surgery when you are awake (you will not feel pain), to minimize damage to functional areas of your brain.
• Radiation therapy: High doses of X-rays destroy brain tumor cells or shrink the tumor in this type of treatment.
• Radiosurgery: This is a type of radiation therapy that uses very focused beams of radiation (gamma rays or proton beams) to destroy the tumor. It is not actually surgery because it does not require an incision (skin cut).
• Chemotherapy: Consists of anticancer drugs that kill cancer cells in your brain and throughout your body. You might receive chemotherapy through an injection into a vein or take it as a pill.
• Chemoradiotherapy: Combination of both chemotherapy and radiotherapy is the best option for the treatment of certain malignant brain tumors.
• Immunotherapy:Immunotherapy uses your body’s immune system to fight cancer. It stimulates your immune system to work more effectively. (This is only used for specific tumors and limited conditions).
• Targeted therapy: Drugs target specific features in cancer cells without harming healthy cells. Your healthcare provider may recommend targeted therapy if you have trouble tolerating the side effects of chemotherapy, such as fatigue and nausea. (It is only used for specific tumors and limited conditions).
• Close observation or active surveillance: If the tumor is very small showing benign features and is not causing symptoms.

 

Prognosis/Outcome

The prognosis (outlook) for people with brain tumors varies greatly. Factors that affect the prognosis include:

• The tumor’s type, grade, and location.
• If the whole tumor has been surgically removed.
• Your age and overall health conditions.

 

Cerebrovascular

A multidisciplinary team of stroke and interventional neurologists, neurosurgeons, neuroradiologists, neurointensivists and rehabilitation specialists who provide expert management of all brain related vascular conditions including stroke, brain aneurysm, arteriovenous malformations and many others.

 

Cerebrovascular Surger

Our team of specialists treat everything from carotid stenosis to complex brain aneurysms.

Our team offers extensive expertise and application of novel technologies, like advanced and detailed neuroangiography, surgical and endovascular services:

• Aneurysm coiling and flow diversion.
• Surgical aneurysm clipping, wrapping and extra/intracranial brain bypass.
• Arteriovenous malformation treatment.
• Carotid and vertebral artery stenting and endarterectomy.
• Endovascular cerebral revascularization and embolectomy for acute stroke.
• Epistaxis treatment.
• Intracranial stenting.
• Minimally invasive clot evacuation for haemorrhages.
• Tumor embolization.

We have sate of the art diagnostic equipment, operating theatres, interventional hybrid cath labs, intensive care unit and rehabilitation center, all focused on optimising patient prognosis and enhance recovery.

 

Peripheral Nerves

Abdali Hospital provides specialized care for patients with acute nerve injuries, entrapment neuropathies, benign nerve tumors and other nerve disorders.

Our neurosurgery team works with other disciplines like neurology and physiotherapy to offer those patients the most scientific and advanced solutions. Starting from accurate diagnosis with advanced nerve and muscle conduction measurements till advanced surgeries and rehabilitation which can improve movement and minimise pain and disability for people with acute nerve injuries, entrapment neuropathies, nerve tumors, and other nerve conditions.

Damaged nerves take a long time to heal (an inch a month or millimetre per day). And, in the process, you can lose your muscle volume. Our specialised neurosurgeons work to restore nerves (reinnervate) in the right time to minimise this risk. They’ll also focus on helping you improve your movement and sensation.

Timing in these cases is the key to success. It’s crucial to see a peripheral nerve neurosurgeon early enough after your nerve injury. This lets us start important testing to find out how and when we want to start your nerve recovery treatment.

Your neurosurgeon will chose based on your condition the best surgical procedure for you. Options like direct repair of the damaged nerves, nerve grafting or transfer to reinnervate your muscle, may in turn improve your functionality. Around 75% of nerve surgeries are quick and you can usually go home the same day. Other surgeries can be more complex, taking longer time needs multiple surgeons and need more recovery time.

Recovery after surgery varies from person to person and depends on many things —your age, timing of surgery and extent of your injury. All of this can impact outcomes (results).