Broadly classified into
1. Primary brain tumors
Extra axial tumors (outside brain matter) Intra axial tumors (inside brain matter)
Bony tumors of skull base intra ventricular tumors
2. Metastatic brain tumors
Tumors which spread to the brain from cancer elsewhere (lung, breast)
The symptoms depend upon tumor size, type & location. They may be caused by pressure on nerve or damage to certain areas of the brain. They may present with features of raised intra cranial pressure (ICP) with headache, nausea, vomiting & in late stages with alteration in level of consciousness. The raised pressure may be due to tumor size, surrounding brain swelling or due to obstruction of CSF pathway leading to hydrocephalus (CSF accumulation in ventricles).Changes in speech, vision, hearing, memory ,mood & personality & imbalance & gait disturbances, weakness & numbness in limbs are other symptoms. Adult onset epilepsy warrants evaluation for brain tumors.
CT & MRI Brain with contrast is the investigations preferred. BT delineates the bony details while MRI images the brain architecture in detail. Specialised tests like functional MRI while dealing with speech & motor area tumors. MR Spectroscopy measures the chemical composition & gives the probable pathological type of tumor.
Craniotomy is usually done for brain tumors. Neuro navigation helps in positioning the skull opening (Craniotomy) accurately overlying the tumor & intra operatively gives a 3-D visualization which helps in
safe, radical excision. Microscope helps in magnification of surgical field & CUSA is an instrument to debulk the tumor. Use of these surgical aides help in removal of tumor safely. Navigation co-ordinates for deep seated tumor
The trans nasal endoscopic surgery is the emerging route for pituitary tumor surgery.Tumor resection is more complete due to improved visualization of the sellar, para sellar & retro sellar areas which are beyond the abilities of microscopic surgeries.
Endoscope Assisted Micro Surgery
Is the combined use of microscopic excision & the endoscope to look around the corners & confirm the surgical clearance.
Deep seated tumors can be biopsied through a small burr hole made in the skull.This avoids the morbidity associated with craniotomy & brain dissections to biopsy deep seated lesions.
Apollo Brain & Spine care centre, Bangalore has the infra structure & experienced specialist Neurosurgical team to handle brain tumors & also medical oncologist with radiation oncologist intervention when required.