Brain Tumour Treatment and Surgery in India
Abnormal
growth of cells within the brain or the central spinal canal is called
brain tumor. Brain tumors can initiate anywhere from the brain cells,
the membranes around the brain (known as meninges), nerves, or glands.
Tumor causes inflammation, consequently placing pressure within the
skull and compressing the brain tissues. Because of its insidious and
infiltrative character in the intracranial cavity all such tumours are
intrinsically serious and life-threatening.
Factors
used to classify Brain tumors include the sites of the tumour, the type
of tissues involved. They can either be cancerous or non-cancerous.
Different types of brain tumors include:
- Acoustic neurinoma : Benign tumor occurring in the 8th cranial nerve (the acoustic nerve) between the pons and the cerebellum. Possibly associated with neurofibromatosis. The term "acoustic neuroma" is actually a misnomer since it this a primary intracranial tumor of the myelin forming cells called "Schwann cells" (schwannoma).
- Astrocytomas : represent the most common type of glioma. They develop from the supporting cells of the brain, which are star-shaped glial cells called astrocytes.
- Oligodendroglioma : These are tumours that are made up of cells known as oligodendrocytes, which produce the fatty covering of nerve cells: the myelin sheath. They are usually slower-growing than astrocytic tumours.
- Ependymoma : Tumor arising from the ependymal cells found along the ventricles and central canal of the spinal cord.
- Brain stem glioma : The tumor occurs in the lowest part of the brain. Brain stem gliomas most often are diagnosed in young children and middle-aged adults
- Craniopharyngioma :This is a benign, congenital tumor. It is cystic and occurs primarily in children and adolescents. Craniopharyngiomas occur in the sellar region. They often involve the third ventricle, optic nerve, and pituitary gland. These are localized tumors that grow by expansion. Malignancy and metastasis are unknown.
- Medulloblastoma : This tumor usually arises in the cerebellum. It is the most common brain tumor in children. It is sometimes called a primitive neuroectodermal tumor
- Meningioma : Benign tumor arising from the meninges, the membranes covering the brain and spinal cord. Meningiomas represent approximately 20% of all primary brain tumors and occur most commonly in middle-aged women.
- Germ cell tumor of the brain : The tumor arises from a germ cell. Most germ cell tumors that arise in the brain occur in people younger than 30. The most common type of germ cell tumor of the brain is a germinoma.
- The pineal gland is just below the area where the two cerebral hemispheres join. Tumours in this part of the brain are extremely rare. They can be made up of different types of cells. The most common tumors are germinomas; others include teratomas, pineocytomas and pineoblastomas.
Primary Malignant Tumor
Tumors
that begin in brain tissue are known as primary brain tumors. Although
primary brain tumors often shed cancerous cells to other sites in the
central nervous system (the brain or spine), they rarely spread to other
parts of the body.
Secondary Malignant Tumor
When
cancer cells spread to the brain from another organ (such as the lung or
breast), is called as a secondary tumor or metastatic tumor. Secondary
tumors in the brain are far more common than primary brain tumors.
Causes of Brain Tumour
Brain tumours develop due to many possible risk factors like:
- Radiation Exposure.
- The risk of brain tumors is augmented by hereditary conditions, including neurofibromatosis, Von Hippel-Lindau syndrome, Li-Fraumeni syndrome, and Turcot syndrome.
Brain Tumour Symptoms
The most universal symptoms are:
- Plain Headaches or headaches accompanied by nausea, perplexity, double vision, weakness or lack of sensation.
- Convulsions in older adults
- Difficulty in ADLs like walking, swallowing, smelling, speaking, reading or writing.
- Dizziness or Vertigo
- Eye abnormalities like drooling of eyes, Contraction or relaxation of Pupils, uncontrollable movements.
- Shivering of hands
- Failure to control the bladder or bowels
- No sense of balance and coordination.
- Weakness in muscles of face, arm, or leg (usually on just one side)
- Personality, mood, behavioral, or emotional changes
Diagnosis of Brain Tumors
A
brain tumor diagnosis usually involves several steps, which can include
a neurological examination, brain scan(s) and/or a biopsy. A
neurological examination is a series of tests to measure the function of
the patient's nervous system and physical and mental alertness. The
doctor also examines the eyes to look for swelling caused by a tumor
pressing on the nerve that connects the eye and brain.
- MRI (Magnetic Resonance Imaging): is a scanning device that uses magnetic fields and computers to capture images of the brain on film. The MRI detects signals emitted from normal and abnormal tissue, providing clear images of most tumors.
- CT Scan (Computed Tomography): combines sophisticated x-ray and computer technology. CT can show a combination of soft tissue, bone, and blood vessels. CT images can determine some types of tumors, as well as help detect swelling, bleeding, and bone and tissue calcification.
- PET Scan: The PET scan measures the brains activity and sends this information to a computer, which creates a live image. Doctors use PET scans to see the difference between scar tissue, recurring tumor cells, and necrosis (cells destroyed by radiation treatment).
- Biopsy: The removal of tissue to look for tumor cells is called a biopsy. A pathologist looks at the cells under a microscope to check for abnormal cells. A biopsy can show cancer, tissue changes that may lead to cancer, and other conditions. A biopsy is the only sure way to diagnose a brain tumor.
Advanced Minimally Invasive Techniques for Brain Tumor Treatment in India
- Brain Suite - Intra-operative MR Navigation Microsurgery
- Trans-Nasal Endoscopic Removal of brain Tumor through the nose
- Stereotactic Radiosurgery - Gamma Knife & Novalis TX
- Tumor Embolization using Neuro Interventional Radiology
1. Brain Suite - Intra-operative MR Navigation Microsurgery - Amongst very few such facilities worldwide
It is
the most advanced Neuro-Surgical Operating Room with high field MR.
This system permits the neurosurgeon to have an MRI study on the patient
during surgery, and if tumour has remained which was hidden to the
human eye, can be detected by special MRI sequences, and can be targeted
using neuro navigation (which works on the same principle as the GPS
system).
The
Brain Suite has two main parts. There is a high-intensity MRI scanner
integrated with an image-guided surgical system. The MRI scanner has a
wide-bore opening allowing a patient to lie on his or her side.
Previously, tumours that could only be accessed from the side of the
skull were not easy to scan. This special MRI system lets doctors repeat
scans during the operation to get more accurate information on the
location, shape and size of the tumour. This minimizes problems
associated with brain tumors shifting during excision.
2. Trans-Nasal Endoscopic Removal of Brain Tumor through the nose
The
endoscopic trans-nasal approach is performed through the nostrils. A
natural passage way exists at the backend of the nose leading into the
sphenoid sinus( an air filled cavity in the depths of the skull) , which
can be enlarged so that the endoscope so that the endoscope and
instruments can pass into this air filled cavity.
From
this region the sella turcica is easily accessed, which is the location
of pituitary gland. Neurosurgeons use this route normally to remove the
tumor from pituitray ( the master gland).
3. Stereotactic Radiosurgery - Gamma Knife & Novalis TX
Gamma Knife RadioSurgery : Advanced Non Surgical Treatment for Brain Tumors
There
is a new ray of hope for patients diagnosed with brain tumor disorders
for treatment by Gamma Knife radiosurgery. Although it's called Gamma
Knife, there is no blade or blood. Instead, it's a stereotactic
radiosurgical treatment that delivers a dose of gamma radiation to the
target with surgical precision and is the most accepted and widely used
radiosurgery treatment in the world.
Novalis
Tx Radiosurgery is one of the most precise, non-invasive radiosurgery
treatments available for cancerous and non-cancerous conditions of the
entire body. It represents a new standard in radiosurgery treatment,
featuring advanced technologies that deliver highly precise treatment
while protecting surrounding healthy tissue and offers one of the
fastest treatment times available-minutes, not hours-giving new hope to
patients with tumors once considered untreatable
4. Tumor Embolization using Neuro Interventional Radiology
Neurointerventional
radiology focuses on diagnosis and treatment of abnormalities of the
nervous system, spine, head and neck. This rapidly advancing specialty
provides imaging of and minimally invasive treatment for conditions,
such as aneurysm or stroke, which previously may have required major
surgery. Tumor embolization is used to close off the vessels supplying
blood to a tumor, especially when the tumor is difficult or impossible
to remove.
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