Brain Tumor

Brain tumors can present with different symptoms and signs, depending on their size, location, and growth rate. Commonly, patients present with:

• Persistent headache, usually worse in the morning and often associated with vomiting
• Weakness of limbs and poor balance
• Poor memory and difficulty with speech
• Epileptic seizures
• Hearing loss and visual loss

Certain brain tumors are hormone-producing. These present either due to pressure effects causing visual field defects in pituitary adenomas. Hormone production examples include:

Acromegaly or Gigantism

Overproduction of growth hormone will cause acromegaly in adults & gigantism in children.

Cushing’s Disease

Overproduction of ACTH, more common in females, where obesity, moon-like face & hunchback are the characteristic features.

Prolactinoma

In this, overproduction of prolactin can cause loss of libido, infertility, watery discharge from the nipple, & irregular periods.

These patients only require medical treatment unless the tumor is big enough to cause visual symptoms.

Classification of Brain Tumors

1. Benign Tumors

• Meningioma: Tumors of the brain covering
• Acoustic neuroma: Tumor of the hearing nerve
• Pituitary Adenoma: Tumor of the pituitary gland
• Craniopharyngioma: Usually in children, located near the visual apparatus

2. Malignant Tumors

Usually arise from brain tissue and are known as Glioma, Ependymoma.

Medulloblastoma: Usually in children and located in the back of the brain, notorious for headache, vomiting, poor balance, and visual loss.

3. Metastatic Tumors

These actually come from the breast, lung, intestine, and lymphomas. Also known as secondaries in the brain & primaries in the organs mentioned above.

Other Brain Diseases Which Need the Attention of a Neurosurgeon

• Hydrocephalus: Increased volume of water (cerebrospinal fluid) in the brain ventricles. This can be high pressure and normal pressure (commonly in old age).
• Congenital Abnormalities:
  • Arachnoid cysts
  • Arnold–Chiari malformation
  • Nasal encephalocele
• Scalp cysts, scars & other lesions: All kinds of scalp & skull bony lumps & bumps are dealt with by our group.

Brain Infection

Brain Abscess

This is usually associated with long-standing ear or sinus infections. Can present with headache, vomiting, weakness of one side, poor balance with or without fever.

Sometimes abscesses are due to tuberculosis and fungus, which can present with the same symptoms & signs but need special attention towards treatment.

Head Injury

Incidence is 300-400 per 100,000 of the population per year. More common in youth and working age. Timely management can save lives and prevent complications.

The best treatment for head injuries is prevention by the use of helmets, seatbelts, and headgear for builders, horse riders, and even cyclists.

In patients who suffer head injuries, operations may be needed for Extradural Clots (clot underneath the bone), Subdural Clots (clot under the brain covering), Intracerebral Clots (clot inside the brain substance), depressed fractures, CSF rhinorrhea, and rarely for epileptic seizures.

How You Prepare

Our healthcare team discusses how to prepare for brain tumor surgery. You’ll need to have a physical exam and testing and take some precautions to prepare your body.

Tests before brain tumor surgery may include:

• Neuropsychological testing: This tests the way that you think, remember, and solve problems. Your healthcare team compares these results with later tests. The results may be used for planning and rehabilitation after surgery.
• Brain imaging (such as MRI or CT scans): These tests take pictures of your brain and spine. They can help your healthcare team plan your brain and spine surgical procedures. The images can determine the size and location of tumors, spinal discs, and any other abnormality in the brain and spine. You may have a contrast injected through a needle placed in a vein in your arm, called an IV. The contrast material helps the tumors and infections to show up more clearly in the scans.
• Functional MRI (fMRI): You may have a special type of MRI called a functional MRI (fMRI) before brain tumor surgery. An fMRI shows small changes in blood flow when you use certain areas of your brain. This can help the surgeon avoid areas of the brain that control functions such as speech or moving your arms or legs.
• Blood tests: It’s common to have a blood test before brain and surgical procedures to check your overall health and levels of chemicals in your blood. These tests are essential for anesthesia whenever required for procedures.