Brain Tumors

Please be advised that the information provided below is meant only to serve as a general overview on brain tumors and some information may not apply to all patients.  It’s important that you consult a medical professional if you have any questions or concerns about any issues that may be related to brain tumors.

A brain tumor is a mass, or growth, of abnormal cells within tissues located in or close to the brain.  Brain tumors can be cancerous (malignant) or non-cancerous (benign), and may begin within the brain itself (primary) or in other parts of the body and spread to the brain (secondary, or metastatic).  They can grow at various speeds, and their growth rate and location will determine how it affects the nervous system.  The cause of brain tumors is still not known and there are only a few confirmed risk factors that have been identified by research.

Primary brain tumors are far less common than secondary tumors, but they include a number of different types based on their locations in the brain.  They can be further classified as either benign or malignant.

Benign: these are usually slow growing tumors with distinct borders that rarely spread to other regions of the brain.  Some of the types of primary tumors in the brain and pituitary gland (a small endocrine gland at the base of the brain) that are usually, but not always benign, include:

  • Chordoma: a rare tumor that occurs in the bones of the skull and spine; they are difficult to treat and requires highly specialized care
  • Craniopharyngioma: these tumors develop near the pituitary gland and most commonly affect children between 5-10 years old
  • Gangliocytoma: a rare tumor that arises from a mature group of nerve cells called ganglion cells; most common in children and young adults
  • Ganglioglioma: similar to gangliocytomas, these tumors arise in both ganglion cells and supportive cells that help neurons stay in their place and function (glia); they are also very rare and are usually grade I (low grade); however, anaplastic gangliogliomas are considered grade III (high grade) meaning they’re usually aggressive, malignant tumors
  • Glomus jugulare: these are rare, slow growing tumors of the blood vessels (vascular) located in the base of the brain in an area called the jugular foramen
  • Meningioma: arise in membranes that support the brain and spinal cord called meninges; they are most typical in older women, but can occur at any age
  • Pineocytoma: arise in pineal gland (another small endocrine gland that produces melatonin, which affects sleep patterns) and typically occur with a buildup of fluid pressure in the brain (hydrocephalus)
  • Pituitary adenoma: a common tumor that also arises in the pituitary gland; may disrupt hormonal balances with different effects throughout the body
  • Schwannoma (acoustic neuroma): a tumor that develops from a type of glia called Schwann cells in the tissue that covers nerves (nerve sheath); these nerves control balance and hearing, which may therefore be affected by these tumors

 

Malignant: these are usually rapid growing, invasive and life threatening.  A glioma is a general term used to describe a category of brain tumors that come from glia, and while many benign tumors are gliomas, almost 80% of malignant tumors are gliomas.  They are named according to the specific type of glia affected and include:

  • Astrocytoma: account for about 50% of all brain tumors; start in astrocytes, a type of glia; most cannot be cured because they spread through normal brain tissue
  • Ependymoma: account for less than 3% of all brain tumors, but up to 10% of those in children; they develop from ependymal cells, which line the cavities (ventricles) of the brain, and rarely spread outside the brain
  • Glioblastoma multiforme (GBM): most common malignant primary brain tumor; arise from glia, often aggressive and tend to infiltrate surrounding brain tissue
  • Medulloblastoma: most common malignant brain tumor in children and less common in adults; starts in the lower back part of the brain and tends to spread through the spinal fluid
  •  Oligodendroglioma: a rare tumor that comes from another type of glia called oligodendrocytes; these can be either low grade or high grade

Secondary brain tumors are much more common and most often occur in people with a history of cancer, though they can also be a sign of cancer that began elsewhere in the body and spread to the brain.  Any cancer can spread to the brain, but some of the most common types include: breast cancer, colon cancer, kidney cancer, lung cancer and melanoma.

Symptoms

Signs and symptoms can vary significantly and depend on the size, location and rate of growth of the tumor.  Some of the more common signs and symptoms are:

  • Changes or difficulties in speech or hearing
  • Confusion in everyday matters
  • Seizures, especially in someone that doesn’t have a history of seizures
  • Vision problems (blurred vision, double vision or loss of peripheral vision)
  • Inability to concentrate
  • Weakness in one part of the body
  • Gradual loss of sensation/movement, numbness or tingling in arms or legs
  • Balance problems or issues with walking
  • Unexplained nausea or vomiting
  • Headaches that gradually become more frequent and severe
  • Personality or behavior changes

Diagnosis

If you have persistent signs and symptoms and are concerned that you may have a brain tumor, please visit us at Raleigh Neurosurgical Clinic Inc. right away.  We’ll evaluate your condition with a full medical history and a physical examination that includes a neurological examination for vision, balance and other possible impairments.  If a tumor is suspected, additional tests may be necessary such as a magnetic resonance imaging (MRI), positron emission tomography (PET) or computed tomography (CT) scan, or an angiogram.  We may also need to perform a biopsy to determine if the tumor is cancerous, which will be performed by taking a tissue sample from your brain and testing it for cancer.

Surgical treatment

Appropriate treatment will also heavily depend on the type, size and location of the brain tumor, as well as your overall health and personal preferences.  The most common treatment options include radiation and chemotherapy; however, surgery is typically the first option once the tumor is diagnosed if it’s located in a part of the brain that’s accessible for an operation.  Unfortunately, not all tumors can be removed due to their location in the brain, and it’s best to discuss your options and the risks involved with each one with us before making any major decisions.

At Raleigh Neurosurgical Clinic Inc., we offer the following surgical procedures for brain tumors:

  • Craniotomy
  • Stereotactic biopsy
  • Stereotactic radiosurgery (gamma knife)
  • Ventriculoperitoneal shunting

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