[vc_row][vc_column width=”2/3″][vc_custom_heading text=”Brain surgeon In Nashik” font_container=”tag:h1|text_align:left” link=”url:https%3A%2F%2Fwww.neurosurgeonnashik.com%2Fbrain-surgery-nashik%2F|||”][vc_custom_heading text=”Brain Tumour- Gliomas” font_container=”tag:h2|text_align:right” use_theme_fonts=”yes”][vc_column_text]A brain tumor or intracranial neoplasm occurs when abnormal cells from within the brain. There are two main types of tumors: malignant or cancerous tumors and benign tumors. Cancerous tumors can be divided into primary tumors that start within the brain, and secondary tumors that have spread from somewhere else, known as brain metastasis tumors.
All types of brain tumors may produce symptoms that vary depending on the part of the brain involved. These symptoms may include headaches, seizures, the problem with vision, vomiting, and mental changes
Gliomas –
Low-grade versus high-grade gliomas — Primary brain tumors are tumors that classified according to their appearance under the microscope. Gliomas are classified into four grades (I, II, III, and IV), and the treatment and prognosis depend upon the tumor grade. Grade I or II tumors are termed low-grade gliomas whereas Grade III and Grade IV are high-grade gliomas. For the most part, it’s unclear why brain tumors develop.
Low-grade astrocytomas usually grow slowly over a period of time. These tumors can arise anywhere in the brain or spinal cord. The most common areas for them to occur are the cerebral hemispheres (frontal, parietal, temporal lobes) and the cerebellum. Tumors can be solid or part cystic.
The grade I gliomas in this class are pilocytic astrocytoma (PA), embryo plastic neuroepithelial tumor (DNET), pleomorphic xanthoastrocytoma (PXA), and ganglioglioma. These are benign tumors.
If the tumor is located in an area where it is safe to remove, then the surgery is done and an attempt is made to remove the tumor as much as possible. Sometimes the treatment includes only monitoring of the tumor with MRI scans every few months. If the tumor appears to be growing then surgery is considered along with radiotherapy.
A stereotactic biopsy may be done where the small sample may be removed from the tumor by stereotactic needle biopsy, which involves the insertion of a needle through the skull into the precise area of the tumor using the stereotactic frame and CT guidance.[/vc_column_text][/vc_column][vc_column width=”1/3″][us_separator height=”90px” size=”custom”][us_image image=”354″ size=”us_600_600_crop” align=”center” onclick=”lightbox” animate=”afl” animate_delay=”1″][/vc_column][vc_column][us_separator show_line=”1″ line_width=”default”][vc_row_inner][vc_column_inner width=”1/3″][us_separator height=”90px” size=”custom”][us_image image=”353″ align=”center” onclick=”lightbox” animate=”afr” animate_delay=”1″][/vc_column_inner][vc_column_inner width=”2/3″][vc_custom_heading text=”Brain Tumour- Meningioma” use_theme_fonts=”yes”][vc_column_text]Meningiomas are a diverse set of tumors arising from the meninges, the membranous layers surrounding the central nervous system. Many meningiomas produce no symptoms throughout a person’s life, and if discovered, require no treatment other than periodic observation. Typically, symptomatic meningiomas are treated with either radiosurgery or conventional surgery.
Convexity meningiomas
These grow on the surface of the brain, often toward the front. They may not produce symptoms until they reach a large size. Symptoms of a convexity meningioma are seizures, focal neurological deficits such as mono paresis, hemiparesis, or headaches.
Sphenoid meningiomas and Middle fossa meningiomas
These meningiomas lie behind the eyes. These tumors can cause visual problems, loss of sensation in the face, or facial numbness. Tumors in this location can sometimes involve the blood sources of the brain (e.g. cavernous sinus, or carotid arteries), making them difficult or impossible to remove completely.
Posterior fossa meningiomas
Posterior fossa tumors lie on the underside of the brain. These tumors can compress the cranial nerves causing facial symptoms or loss of hearing. Petroclival tumors can compress the trigeminal nerve, resulting in sharp pain in the face (trigeminal neuralgia) or spasms of the facial muscles.
Tentorial Meningiomas and Periocular Meningiomas
These arise in the posterior part of the brain can cause headaches, or other signs cerebellar compression such as difficulty walking.
Intraventricular meningiomas
Intraventricular meningiomas are associated with the connected chambers of fluid that circulate throughout the central nervous system. They can block the flow of this fluid causing pressure to build up, which can produce headaches and dizziness.
Intraorbital meningiomas
Intraorbital meningiomas grow around the eye sockets of the skull and can cause pressure in the eyes to build up, resulting in a bulging appearance. They can also cause an increasing loss of vision.
Incidence
Meningiomas account for about 36.1% of all primary brain tumors, which are tumors that form in the brain or its coverings. They are most likely to be found in adults older than 60; the incidence appears to increase with age. Rarely are meningiomas found in children. They occur about twice as often in women as in men.
Cause
Researchers are studying meningiomas carefully to find out what causes them. Between 40% and 80% of meningiomas contain an abnormal chromosome 22. The cause of this abnormality is not known.
Meningioma Symptoms
Meningiomas usually grow slowly and may reach a large size before interfering with the normal functions of the brain. The resulting symptoms depend on the location of the tumor within the brain. The most common symptoms are,
- Headaches
- Seizures
- Blurred vision
- Personality changes
- Weakness in arms or legs
- Numbness
- Speech problems
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Acoustic Neuroma Treatments
There are three main courses of treatment for acoustic neuroma:
- Observation
- Surgery
- Radiation therapy
Observation is also called watchful waiting. Because acoustic neuromas are not cancerous and grow slowly, immediate treatment may not be necessary. Often monitoring of the tumor is done with periodic MRI scans. Simple observation without any therapeutic intervention has been used in the following groups of patients:
- Elderly patients
- Patients with small tumors, especially if their hearing is good
- Patients with medical conditions that significantly increase the risk of the operation.
- Patients with a tumor on the side of an only hearing ear or only seeing the eye.
Surgery
Microsurgical tumor removal can be done at one of three levels: subtotal removal, near total removal or total tumor removal. Subtotal removal is indicated when anything further risks life or neurological function. In these cases, the residual tumor should be followed for risk of growth (approximately 30%). Periodic MRI studies are important to follow the potential growth rate of any tumor. Near total tumor removal is used when small areas of the tumor are so adherent to the facial nerve that total removal would result in facial weakness. The piece left is generally less than 1% of the original and poses a risk of regrowth.
The surgical approach taken depends on the location of the tumor, its size and the relative importance of hearing preservation. Complete removal is possible in most cases. The risks of surgery include,
- Mortality (risk about 1%)
- CSF leak and meningitis
- Hydrocephalus
- Cerebellar injury
- Stroke
- Epilepsy
- Facial paralysis (either partial or complete)
- Hearing loss
- Balance impairment
- Persistent headache
Radiation therapy is recommended in some cases for acoustic neuromas. Radiation therapy for this condition is usually delivered in one of two ways:
- Single fraction stereotactic radiosurgery, in which many hundreds of small beams of radiation are aimed at the tumor in a single session.
- Multi-session fractionated stereotactic radiotherapy (FRS), which delivers smaller doses of radiation daily, generally over several weeks. Early studies suggest multi-session therapy may preserve hearing better than SRS.
[/vc_column_text][/vc_column_inner][vc_column_inner width=”1/3″][us_separator height=”90px” size=”custom”][us_image image=”355″ align=”center” animate=”afr”][/vc_column_inner][/vc_row_inner][us_separator show_line=”1″ line_width=”default”][vc_row_inner][vc_column_inner width=”1/3″][us_separator height=”90px” size=”custom”][us_image image=”357″ align=”center”][/vc_column_inner][vc_column_inner width=”2/3″][vc_custom_heading text=”Brain Tumour – Pituitary tumour” use_theme_fonts=”yes”][vc_column_text]Pituitary Tumour
The pituitary gland is a pea-sized structure located at the base of the brain, just below the hypothalamus and attached to it with pituitary stalk through which hypothalamus control the function of the pituitary gland. The pituitary gland controls the function of most other endocrine glands and is therefore sometimes called the master gland.
The pituitary is divided into three sections: the anterior, intermediate, and posterior lobe. Anterior lobe hormones.
Pituitary adenomas
These benign tumors do not spread outside the skull. They usually remain confined to the sella turcica (the tiny space in the skull that the pituitary gland sits in). Sometimes they grow into the walls of the sella turcica and surrounding blood vessels, nerves, and coverings of the brain. They don’t grow very large, but they can have a big impact on a person’s health.
There is very little room for tumors to grow in this part of the skull. Therefore, if the tumor becomes larger than about a centimeter (about half an inch) across, it may grow upward, where it can compress and damage nearby parts of the brain and the nerves that arise from it. This can lead to symptoms such as vision changes or headaches.
Pituitary adenomas can be divided into 2 categories based on size:
- Microadenomas are tumors that are smaller than 1 centimeter (cm) across. Because these tumors are small, they rarely damage the rest of the pituitary or nearby tissues. But they can cause symptoms if they make too much of a certain hormone.
- Macroadenomas are tumors 1 cm across or larger. Macroadenomas can affect a person’s health in 2 ways. First, they can cause symptoms if they make too much of a certain hormone. Second, they can cause symptoms by pressing on normal parts of the pituitary or on nearby nerves, such as the optic nerves.
- Functional versus non-functional adenoma
- Pituitary adenomas are also classified by whether they make too much of a hormone and, if they do, which type they make. If a pituitary adenoma makes too much of a hormone it is called functional. If it doesn’t make enough hormones to cause problems it is called non-functional.
Functional adenomas: Most of the pituitary adenomas that are found make excess hormones. The hormones can be detected by blood tests or by tests of the tumor when it is removed with surgery. Based on these results, adenomas are classified as:
- Prolactin-producing adenomas (prolactinomas), which account for about 4 out of 10 pituitary tumors
- Growth hormone-secreting adenomas, which make up about 2 in 10 pituitary tumors
- Corticotropin (ACTH)-secreting adenomas (about 5% to 10%)
- Gonadotropin (LH and FSH)-secreting adenomas (less than 1%)
- Thyrotropin (TSH)-secreting adenomas (less than 1%)
Non-functional adenomas: Pituitary adenomas that don’t make excess hormones are called non-functional adenomas or null cell adenomas. They account for about 3 in 10 of all pituitary tumors that are found. They are usually detected as macroadenomas, causing symptoms because of their size as they press on surrounding structures.
Signs and Symptoms of Pituitary Tumors:
Not all pituitary tumors cause symptoms.
- The first symptoms often depend on whether the tumor is functional(releasing excess hormones) or non-functional (not releasing excess hormones) and micro or macroadenoma
- Functional adenomas can cause problems because of the hormones they release.
- Small Non-functional adenomas that cause no symptoms are sometimes found because of an MRI or CT scan done for other rea
- Tumors that aren’t making excess hormones often become large (macroadenomas) before they are noticed. These tumors cause symptoms when they press on nearby nerves, parts of the brain, or other parts of the pituitary.
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Glioblastoma Surgery
The first treatment step is surgery to remove as much tumor as possible. Surgery is almost always followed by radiation. As glioblastoma wildly invade and infiltrate normal surrounding brain tissue it is impossible to completely excise the tumor.
The primary objective of surgery is to remove as much of the tumor as possible without injuring the surrounding normal brain tissue needed for normal neurological function (such as motor skills, the ability to speak and walk, etc.). However, GBMs are surrounded by a zone of migrating, infiltrating tumor cells that invade surrounding tissues, making it impossible to ever remove the tumor entirely.
Surgery provides the ability to reduce the amount of solid tumor tissue within the brain, remove those cells in the center of the tumor that may be resistant to radiation and/or chemotherapy and reduce intracranial pressure. Surgery, by providing a debulking of the tumor, carries the ability to prolong the lives of some patients and to improve the quality of remaining life.
Radiotherapy
After surgery, when the wound is healed, radiation therapy can begin. The goal of radiation therapy is to selectively kill the remaining tumor cells that have infiltrated the surrounding normal brain tissue. In standard external beam radiation therapy, multiple sessions of standard-dose “fractions” of radiation are delivered to the tumor site as well as a margin in order to treat the zone of infiltrating tumor cells.
Chemotherapy
Patients undergoing chemotherapy are administered special drugs designed to kill tumor cells. Chemotherapy with drug Temozolomide is the current standard of treatment for GBM. The drug is generally administered every day during radiation therapy and then for six to 12 cycles after radiation. Each cycle lasts for 28 days, with Temozolomide given the first five days of each cycle, followed by 23 days of rest.
While the aim of chemotherapy is long-term tumor control, it does so in only about 20 percent of patients. The decision to prescribe other forms of chemotherapy for tumor recurrence is based on a patient’s overall health, type of tumor and extent of cancer. Before considering chemotherapy, patients should discuss it with their oncologists and/or neuro-oncologists.
Symptoms Of Glioblastoma
- Headache: The most common symptom, it’s caused by increased pressure in the brain
- Hemiparesis
- Nausea
- Seizure
- Progressive memory
- Personality deficit
- Vomiting
- Brain surgeon In Nashik
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