Brain talk

KOCHI: Dr Arun Oommen (Mch. Neurosurgery)
Brain tumor refers to an abnormal formation of cells inside the brain.  There are two main types of brain tumors: cancerous (malignant) tumors and indolent (benign) tumors.    Warning signals Tumours produce symptoms either due to compression or irritation of the brain. Following are the symptoms to look out forHeadache occurring in later onset of life and gradually increasing in intensity. There can be a constant aching pain with pain free intervals in between.  The headache usually peaks in the morning.

Projectile vomiting mostly on waking up in the morning. Here, the vomiting may not be preceded by nausea. Vomiting can offer temporary relief to the headache.New onset seizures can be focal seizures involving only part of the body or it can be generalized seizures. Weakness or numbness that keeps increasing and can involve only one limb or one side of the body. Visual problems especially when it involves the optic nerve or pituitary gland.

Cognitive problems like memory problems,  behavioral changes, language problems and confusions may occur suddenly.Difficulty in speech, sudden Gait disturbances, imbalance, lack of coordination or weakness of facial muscles

 Risk factors 
Majority of brian tumours don’t have any specific causative factors. The best known environmental risk factor for brain tumors is radiation exposure. Impaired immune systems have an increased risk of developing  lymphomas  (cancers of lymphocytes ). In rare cases (5%) brain cancers run in families. 

Treatment
Tumours like Meningiomas , Certain Gliomas,   Pituitary adenomas ,Nerve sheath tumors , germ cell tumours, hemangioblastomas, cavernomas,  and certain Lymphomas are curable.Survival rates in brain tumors depend on the type of tumor, size, area involved and early detection, apart from age, overall health and extent of surgical tumor removal required.The primary and most desired course of action is surgical removal (resection) via craniotomy.

Endoscopic surgeries are also being done. With ultramodern operating microscopes, neuronavigation systems, cavitron ultrasonic aspirator, endoscopes and other sophisticated instruments, the safety and success rate for brain tumour surgery has improved. Radiotherapy is the most commonly used treatment for brain tumors. Radiosurgery is a treatment method that uses computerized calculations to focus radiation at the site of the tumor while minimizing the radiation dose to the surrounding brain. Chemotherapy can improve survival in 20% brain cancers. Role of pharmacological therapy is limited  except for anti epileptics (for controlling fits) and steroids( reduce brain oedema)

The author is a senior consultant neurosurgeon at VPS Lakeshore Hospital, Kochi.