Neurosurgery for Brain Tumors: Diagnosis, Treatment Options, and Prognosis

Brain tumors can be either malignant (cancerous) or benign (noncancerous), and they may affect both children and adults. However, whether malignant or not, brain tumors may interfere with brain function if they grow large enough to exert pressure on surrounding tissues. There are various treatments available for brain tumors.

What Are The Signs And Symptoms Of Brain Tumors?

Some people with a brain tumor have no symptoms, especially if it is small.

The signs and symptoms of a brain tumor vary according to its location, size, and type. Symptoms may include:

Headaches that worsen in the morning or cause sleep disturbances.

Seizures

Difficulty thinking, speaking, and understanding language

Personality change

Weakness or paralysis in one area or side of your body

Balance issues or dizziness

Visual difficulties

Hearing issues

Facial numbness and tingling;

Nausea or vomiting.

Confused and disoriented

Diagnosis

If your doctor suspects you have a brain tumor, some tests will be prescribed to confirm it. These could include:

A Neurological Exam

A neurological exam is a diagnostic tool used to assess brain function and potential brain tumors. It can assist your provider in determining which portion of your brain may be having problems. It includes checking vision, hearing, balance, coordination, strength, and reflexes.

Head CT Scan

A head CT scan is a widely available imaging test that can detect brain problems and may be the first test if headaches or other symptoms are present. The results give your healthcare provider clues to decide what test to do next. If your doctor believes your CT scan suggests a brain tumor, you might require a brain MRI.

Brain MRI

A brain MRI is a more detailed imaging technique that uses magnets to produce images of the brain. MRI is often used to detect brain cancers because it provides a clearer picture of the brain than other imaging techniques. This makes it easier to spot small tumors. It can assist your doctor in identifying a brain tumor and healthy brain tissue.

To get more detailed images, a specialized MRI is sometimes required.

Functional MRI

Functional MRI shows which parts of the brain control important tasks, helping healthcare providers plan surgery and treatments. 

Magnetic Resonance Spectroscopy

Magnetic Resonance Spectroscopy measures the levels of certain chemicals in tumor cells, which may give clues about the types of brain cancer you have.

Magnetic Resonance Perfusion

Magnetic Resonance Perfusion measures the amount of blood in different parts of the tumor. The areas of the tumor with the most blood may be the most active.

PET Scan Of The Brain

PET scans can detect some brain tumors, particularly those growing quickly, such as glioblastomas and oligodendrogliomas. They are less effective for benign tumors, and not everyone with a brain tumor requires a PET scan.

Brain Biops

A brain biopsy is a surgical procedure that involves the removal of tumor tissue for laboratory testing. It is carried out during surgery or with a needle, and imaging techniques like CT and MRI are used to decide the needle's route. If surgery is unable to reach the tumor, a biopsy can be done. However, there is a risk of bleeding and tissue injury.

Brain Tumor Grade 

Brain tumor grade is determined by checking tumor cells in a lab. There are no stages for brain tumors, unlike other cancers, which shows the spread of cancer. 

Treatment

Treatment for a brain tumor depends on its type, size, grade, and location and may include surgery, radiation therapy, radiosurgery, chemotherapy, or targeted therapy. Your healthcare team considers your health and preferences when deciding on a treatment plan. Small, benign tumors may not require immediate treatment and brain MRI scans may be performed several times to monitor tumor progression. The primary treatment options for a brain tumor are:

• Surgery
• Radiation therapy
• Chemotherapy
• Targeted drug therapy
• Tumor-treating fields
• Follow-up care and rehabilitation

Brain Tumor Surgery

Surgery is the most common treatment for brain tumors, and in many cases, it is the only one required. Depending on the size and location of the brain tumor, there are several surgical techniques available for removal.

Learn more about brain tumor surgery or investigate the different procedures:

• Subtotal resection refers to the removal of only a portion of a brain tumor, as the removal of a portion of your brain tumor may help relieve your symptoms.
• Craniotomy: It is the temporary removal of a section of the skull to give doctors access to the brain.
• Awake Brain Tumor Surgery: Patients are sedated and comfortable yet awake during surgery, allowing surgeons to guarantee that normal brain function is not disrupted.
• Neuroendoscopy: Surgeons enter the brain through other parts of the body, such as the nose, to better access specific areas and reduce scarring.
• Endoscopic Brain Surgery is a common procedure to treat pituitary tumors. It is done using an endoscope. These tumors develop directly behind the nasal cavity. The long, thin tube is inserted via the nose, sinuses, and into the brain.
• MRI-Guided Laser Ablation and Laser Interstitial Thermal Treatment (LITT): Radiologists and neurosurgeons utilize computer technology and intraoperative imaging to pinpoint tumors and precisely eliminate malignant cells with lasers or heat.
• Biopsy: A biopsy is when doctors take a small sample of brain tumor tissue and analyze it under a microscope.
• Neuroplastic surgery is a neurosurgical method that protects and restores the appearance and anatomy of the skull following invasive treatments.

Radiation Therapy

Radiation therapy is a highly effective method used to treat brain tumors, using energy beams from sources like X-rays and protons. This therapy can be done with a typical treatment plan of five days a week for 2 to 6 weeks. 

The radiation can focus on the tumor area or the entire brain, with whole-brain radiation being most common for brain tumors that spread to other parts of the body.

Proton therapy, a newer form of radiation therapy, is less widely available but may help treat brain tumors in children and close areas.

Radiation therapy for tumors often involves radiation, which can cause side effects such as fatigue, headaches, memory loss, scalp irritation, and hair loss.

Radiosurgery

Stereotactic Radiosurgery

It is an intense form of radiation treatment used to treat brain tumors. It involves aiming beams of radiation from various angles at the tumor, delivering a large dose of radiation that kills the tumor cells.

Linear Accelerator Radiosurgery

It is also called LINAC machines. LINAC machines are known by their brand names, such as CyberKnife, TrueBeam, and others.

Gamma Knife Radiosurgery

A gamma knife machine aims at many small beams of radiation at the same time. The beams are made of gamma rays.

Proton Radiosurgery

Proton radiosurgery uses beams made of protons. This is the newest type of radiosurgery. 

Chemotherapy

Chemotherapy is a treatment method for brain tumors, using strong medicines to kill tumor cells. It can be taken or injected, and it can be combined with radiation therapy. Side effects include nausea, vomiting, and hair loss.

Targeted Therapy

Targeted therapy targets specific chemicals in brain tumors, potentially killing them. Tests may be conducted to determine if targeted therapy is effective for you or not.

Prognosis

The prognosis of a brain tumor is determined by the healthcare team using diagnostic tests, considering factors such as:

• Tumor Type: Each tumor has a different prognosis.
• Tumor Size and Location: Smaller tumors in less vital parts of the brain are usually easier to remove surgically.
• Patient age and overall Health: Younger patients and those in good health typically have better treatment outcomes.
• Surgery Extent: In some cases, the tumor can be completely removed, and in others, only a portion of it can be removed.
• Other Treatments: Surgery is frequently done in addition with other treatments, like radiation therapy or chemotherapy, to improve the overall prognosis.

Recovery After Treatment

After treatment, a patient may require assistance to regain function in the brain affected by the tumor, including motor, speech, and visual functions. Healthcare providers may recommend physical, occupational, speech, and tutoring services for specific needs.

Conclusion

Brain Tumors are difficult to deal with, but with correct information and a positive mindset, you can get through it. Remember that early diagnosis is important, and there are several treatment options available, including surgery, radiation, and medication. With advancements in technology treatment outcomes have improved up to a large extent and persons suffering from brain tumor can return to normal life after proper treatment and care after treatment.