Brain Tumor its Symptoms and Treatment

A brain tumor is the enlargement of abnormal cells within the brain . There are two main types of tumors: Benign tumors and Malignant or Cancerous tumors. Cancerous tumors can be divided into primary tumors that started within the brain and those that spread from others part known as secondary or brain metastasis tumors.

Cause:

The cause of most cases is unknown. Mutations and deletions of TP53, tumor suppressor genes might be the cause of some forms of brain tumors. Inherited diseases, such as Von Hippel-Lindau syndrome , multiple endocrine neoplasia , neurofibromatosis type 2 are at high risk of developing brain tumors.

Risk factors may include a number of genetic syndrome such as neurofibromatosis, exposure to the chemical vinyl chloride, Epstein-Barr virus and ionizing radiation .

Types:

Primary brain tumors:

It remain within the intracranial cavity or central spinal canal and rarely metastasize to other organs. cancerous cells of a primary neoplasm cannot enter the bloodstream and get carried to another location in the body due to the blood brain barrier. It is invasive (i.e. they will expand spatially and penetrate into the space occupied by other brain tissue and compress those brain tissues). The more malignant primary brain tumors will infiltrate the surrounding normal tissue.

The most common primary brain tumors are:

• Gliomas (50.4%)
• Meningiomas (20.8%)
• Pituitary adenomas (15%)
• Nerve sheath tumors (8%)

In adults common types are: meningiomas and astrocytomas such as glioblastomas. In children the most common type is medulloblastomas.

Secondary brain tumors :

It is the metastatic tumors that invaded the intracranial sphere from cancers originating in other organs. It is a cancerous neoplasm that has originated from another organ in the body and cancer cells have leaked from that primary tumor and then entered the lymphatic system and blood vessels . It circulate through the bloodstream, and are deposited in the brain. There, these cells continue to grow and divide, and becomes another invasive neoplasm of the primary cancer's tissue. It is very common in the terminal phases of patients with an incurable metastasized cancer; the most common types of cancers that bring about secondary tumors of the brain are lung cancer, breast cancer, malignant melanoma , kidney cancer, and colon cancer (in decreasing order of frequency).

Secondary brain tumors are the most common cause of tumors in the intracranial cavity.

Signs and symptoms:
The most frequent symptoms of brain tumors include:

• Headaches that tend to be worse in the morning and ease during the day
• Seizures or convulsions
• Nausea or vomiting
• Weakness that is felt in the arms or legs
• Stumbling or lack of coordination in walking
• Abnormal eye movements or changes in vision
• Drowsiness
• Changes in personality or memory
• Changes in speech

Diagnostic tests can be done to identify the cause of symptoms is a brain tumor or it is a primary or secondary one.

Diagnosis:
Diagnosis is usually by medical examination along with computed tomography or magnetic resonance imaging .This is then often confirmed by biopsy .Based on the finding the tumors are divided into different grades or severity .

Neurologic exam: The physician checks vision, hearing, alertness, muscle strength, coordination, and reflexes and also examines eyes to look for swelling caused by a tumor pressing on the nerve that connects the eye and the brain.

MRI: A large machine with a strong magnet linked to a computer is used to make detailed images of areas inside head. Sometimes a special dye (contrast material) is injected into a blood vessel in arm or hand to help show differences in the tissues of the brain. The images can show abnormal areas, such as a tumor.

CT scan: An x-ray machine linked to a computer takes a series of detailed images of head. A contrast material is injected into a blood vessel in arm or hand to makes abnormal areas visible.

Angiogram: A dye injected into the bloodstream makes blood vessels in the brain visible on an x-ray. If a tumor is present, the x-ray may show the tumor or blood vessels that are present in the tumor.

Spinal tap: A sample of cerebrospinal fluid (the fluid that fills the spaces in and around the brain and spinal cord) is taken. This procedure is performed with local anesthesia. The doctor uses a long, thin needle to remove fluid from the lower part of the spinal column. A spinal tap takes about 30 minutes. Flat position is required for several hours afterward to keep from getting a headache . Sample is sent in lab for analysis of cancer cells or other signs of problems.

Biopsy: The removal of tissue to analyze tumor cells is called a biopsy. A pathologist looks at the cells under a microscope to check for abnormal cells. A biopsy can determine cancer, tissue changes that may lead to cancer, and other conditions. Surgeons can obtain tissue to look for tumor cells in two ways:

1. Biopsy at the same time as treatment: The surgeon takes a tissue sample when performing surgery to remove part or all of the tumor.
2. Stereotactic biopsy: Local or general anesthesia is given and wear a rigid head frame for this
   procedure. The surgeon makes a small incision in the scalp and drills a small hole (a burr hole)
   into the skull. CT or MRI is used to guide the needle through the burr hole to the location of the
   tumor. The surgeon withdraws a sample of tissue with the needle. A needle biopsy may be used
   when a tumor is deep inside the brain or in a part of the brain that can't be operated on.

Treatment: 

It includes some combination of surgery, radiation therapy and chemotherapy. Anticonvulsant medication is needed in those who have a seizure. Dexamethasone and furosemide may be used to decrease swelling around the tumor. Some tumors grow sufficiently slowly and it need to be observed.

Secondary or metastatic brain tumors are more common than primary brain tumors, with about half of metastasis coming from lung cancer.