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Op. Dr. Selçuk Gözcü Beyin Sinir ve Omurilik Cerrahisi

BRAIN TUMORS

BRAIN TUMOR SYMPTOMS

Symptoms of brain tumor can be listed as vomiting, severe headache, speech and visual impairment, and weakness in arms and legs. People with symptoms of a brain tumor should consult a neurosurgeon or neurologist. A fully equipped center, team approach and multidisciplinary treatment approach are very important for success in brain tumors, which are common in society.

WHAT IS BRAIN TUMOR?

Tumor means a tissue that forms in a place in our body that should not be there, or the uncontrolled growth of any tissue where it should be. According to this definition, the sebaceous glands and moles that we do not pay much attention to in our body can also be considered as tumors. However, although not all tumors are lethal, brain tissue has an exceptional situation in brain tumors. Benign tumors can also be lethal because the brain is located in a closed chamber within the skull. For this reason, although not all brain tumors are lethal, they must be kept under control and treated correctly.

WHY AND HOW DO BRAIN TUMOR OCCUR?

There are two important answers about how brain tumors form. The first is that the brain develops from its own cells, and the other is that the tumor spreads to the brain from another region. If the brain tumor develops from its own cells, it is divided into benign (benign) and malignant (malignant). The incidence of brain tumor in society is between 3-5 per 100 thousand people. The incidence is higher in blondes and in men than in women. Benign meningiomas are more common in women. Brain tumors occur in almost every age range. At the same time, brain tumors differ according to age. For example; Malignant brain tumors are more common in children and those over the age of 60. Benign brain tumors are more common in the remaining age groups.

WHAT ARE THE SYMPTOMS OF BRAIN TUMOR?

Brain tumor symptoms play a very important role in the diagnosis of brain tumor. When benign or malignant brain tumors reach a certain size, they cause increased pressure inside the head. Accordingly, they can push the brain to one side or invade the brain’s tissue or nerves and disrupt its functions. The question of how to understand the symptoms of brain tumor is a topic that many people wonder about. Brain tumor symptoms occur with increased intracranial pressure. Increased head pressure can also be understood by some symptoms. If you experience headache, apathy (slowness in movements and facial expressions), nausea, vomiting, epileptic seizures, weakness in some parts of your body depending on where the tumor is located in the brain, personality disorders and impairment in some of your abilities (such as calculating, writing) are considered symptoms of a brain tumor. One of the symptoms of brain tumor is hormonal disorders and related clinical symptoms. For example, it is necessary to pay attention to changes such as early puberty, enlargement of hands and feet, menstrual cycle disorders, hyperthyroidism, cortisol deficiency or excess. If you notice even one of the symptoms of a brain tumor, you should definitely see a specialist doctor.

BRAIN TUMOR TYPES

Brain tumors are divided into two: primary and secondary. Primary brain tumors, which consist of the brain’s own cells, can be benign or malignant. Secondary brain tumors occur when cancerous cells that appear elsewhere in the body spread to the brain. Benign brain tumors: Benign brain tumors do not originate from brain cells. Benign brain tumors, which have a very slow growth rate, can be easily separated from brain tissue. Thus, all or almost all of the benign tumors can be removed. Postoperative results are very good. Benign brain tumors removed through surgical intervention rarely reoccur and are unlikely to spread to other parts of the body. Even though it is not cancerous, when a benign brain tumor reaches a certain size, it can cause serious health problems by putting pressure on sensitive areas of the brain. There may be a risk of a benign brain tumor turning into a cancerous brain tumor over time. Malignant brain tumors: Malignant brain tumors formed by brain cancer cells grow faster than benign tumors and can damage nearby brain tissue. For this reason, it is very difficult to remove them completely by surgery. Because in malignant brain tumors, the tumorized tissue is the tissue that performs brain functions, and any tissue removed surgically means loss of function. In malignant brain tumors, tumor regrowth may occur after surgery. At the same time, metastatic tumors that spread to the brain tissue from a different part of our body are also considered malignant tumors. Glioblastoma multiforme (gbm), also known as glioblastoma, is known as a grade IV astrocytoma. It is among the lethal and aggressive tumors. Glioblastoma multiforme (gbm) is a rare disease with a rate of 2-3 per 100 thousand. Glioblastoma multiforme (GBM) is known as the most common brain cancer and the most difficult to treat. Glioblastoma multiforme (gbm) may present with symptoms such as headache, memory loss and behavioral changes. At the same time, glioblastoma multiforme (gbm) treatment methods include chemotherapy, radiotherapy and surgery.

How is a brain tumor diagnosed? How is it diagnosed?

The issue of how brain tumors are understood is very important. Choosing a fully equipped hospital affects the success of both diagnosis and treatment. A rough idea about the type of brain tumor is obtained by MRI (Magnetic Resonance Imaging), which is the gold standard in brain tumor diagnosis, and then it is clearly understood whether there is a brain tumor or not by pathology laboratory examination. Detailed demonstration and identification of brain tumors with advanced radiological imaging methods are extremely important for planning treatment. Technological developments provide great convenience in diagnosis and identification of pathologies. “CT angiography” performed by administering contrast material to the patient has an important place in the diagnosis of cerebrovascular diseases. In this way, the structure of the vessels can be easily visualized. The prominent imaging method in the evaluation of brain tissue and diseases is MRI, that is, “Magnetic Resonance”. While it is possible to obtain information only about the anatomical and structural state of the brain with standard MRI imaging, new technologies can also obtain information about the metabolic, biochemical and hemodynamic structure of the brain. Performing a biopsy using known methods to obtain information about lesions in the brain can be difficult, risky and time-consuming. With advanced MRI imaging methods, it can be determined whether the suspected lesion in the brain is a tumor or not. With advanced MR imaging methods such as diffusion MR, DTI MR, Functional MR, Perfusion MR and MR spectroscopy, the extent of the tumor, its type, metabolic-biochemical structure, and its relationship with the areas and pathways that enable speech, vision and movement can be evaluated. Data obtained with advanced MR imaging methods help determine treatment approaches.

WHAT ARE THE BRAIN TUMOR TREATMENT METHODS?

One of the most important parts of brain tumor treatment is that the treatment is personalized. The aim of brain tumor treatment is to fight the tumor and prolong life as much as possible without compromising the patient’s quality of life. The most important factors in brain tumor surgery are the type of tumor, location, age of the patient, general condition, and whether the patient has additional problems that may affect the decision for surgery. Therefore, a personalized treatment is applied and the risk of success increases. Treatment of malignant brain tumors is usually done surgically. In addition to brain tumor surgery, sometimes chemotherapy, sometimes radiotherapy, and sometimes combined treatment with both are performed. The most important thing in brain tumor surgeries is that the surgery is performed by teams specialized in brain tumors. Radiotherapy devices equipped with stereotaxic targeting systems can significantly increase the effectiveness of treatment while reducing the possible side effects of brain tumor surgery. Brain biopsy is performed in tumors that cannot be removed by surgery. In the brain biopsy method, biopsy is performed in cases where the tumor is deeply located and does not cause increased intracranial pressure, but the type of tumor needs to be learned in order to determine the treatment. Accordingly, through a small hole opened close to the tumor, the 3D coordinates of the tumor are calculated and taken with the help of a needle. You are discharged after approximately 1 day.

BRAIN TUMOR SURGERY

Microsurgical method is used in the treatment of brain tumor. Microsurgery is a procedure that aims to remove the entire tumor. With the microsurgery method, intracranial pressure is reduced and the regional effects of the brain tumor can be reset. At the same time, if the brain tumor is in an area that allows us to speak, see or move, Microsurgery ensures that these areas are not damaged during the surgery and minimizes the risks that may develop. Therefore, it is very important that the hospital chosen for brain tumor treatment uses advanced technology. Other methods that can be used to completely remove the brain tumor while preserving healthy brain tissue and to prevent the risks of permanent disabilities and brain cancer are as follows;
Neuronavigation; With Neuronavigation, one of the brain tumor treatment options, the patient’s film is uploaded to the system and the most accurate direction to the tumor is determined before surgery. Likewise, the localization of the structures nearby during the surgery is also determined.
Neuromonitoring: This method helps to greatly reduce facial or arm and leg paralysis that may occur after brain tumor surgery. Before the brain surgery begins, signals are received from electrodes placed on the patient’s face, arms and legs by the neurologist throughout the surgery. When the signal drops, the surgeon is informed and warned that he is in a sensitive area.
Intraoperative Ultrasonography: During brain tumor surgery, brain ultrasound is performed and how much tumor is removed is calculated. Intraoperative Ultrasonography reduces the risk of residue remaining, especially in tumors that are difficult to separate from brain tissue.
Endoscopy: It is useful to provide a wide angle of view from a small area, especially in pituitary tumors and intraventricular tumors in areas where narrow corridors are used in brain tumor surgery.
Gliolan Staining Technique: The patient is given a liquid to drink before the surgery. During surgery, normal brain tissue and tumor tissue are seen in different colors with the special filter of the surgical microscope. With this method, while normal brain tissue damage is minimized, tumor removal is maximized and the risk of the patient suffering neurological loss is reduced.
Awake craniotomy: In the surgery of the sensitive areas responsible for arm and leg movements, called the speech center and “motor area”, the surgery is performed by keeping the patient awake. In this way, the person’s speech and arm and leg movements can be controlled instantly. In this way, the success of the surgery increases.
Intraoperative CT: Computerized tomography can be taken during the surgery and the condition reached during the surgery can be displayed. This technology reduces the risk of re-operation.
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