The term of brain tumour is usually applied to most intracranial tumours. These may originate from the brain itself or from the meninges, the envelopes of the brain. They usually cause signs of raised intracranial pressure such as headaches, nausea, vomiting or double vision. If they irritate the brain surface, tumours may cause seizures. Finally, they may irritate or even destroy important zones of functional brain, causing weakness potentially leading to hemiplegia, or speech disorders potentially leading to aphasia.
Surgical treatment of these tumours more and more often involve using the latest development in high tech medicine : computer assisted surgery, neuronavigation, stereotaxic or endoscopic surgery, ultrasonic aspirator, operative microscope, micro instruments, high speed drills and preoperative embolizations. Although these techniques are constantly progressing, keep pushing further the boundaries or surgery, allowing longer survival and better quality of life, brain tumours remain a challenge in contemporary medicine.
Gliomas come from the brain itself, caused by multiplication of glial brain cells. Some gliomas are benign (pilocytic astrocytomas, oligodendrogliomas), others are malignant (anaplasic astrocytoma, glioblastoma).
- Benign gliomas are usually infiltrative tumours, and cannot always be cured by surgery alone. As recurrences are always possible, regular follow up is mandatory, even after surgery. Aggressive surgery is not always necessary and sometimes a single biopsy may be enough. The prognosis of such tumours is generally favourable.
- Malignant gliomas are much more aggressive tumours and their prognosis is less favourable. Anaplasic astrocytoma and glioblastoma may be treated by stereotaxic biopsy alone, but more often need surgical resection whenever possible. Radiotherapy or chemotherapy may also be considered. These tumours usually recur rapidly, after a few month for glioblastoma.
Brain metastases are malignant tumours arising from another cancer tumour located elsewhere in the body (kidney, breast, lung, colon, melanoma or others). When solitary and symptomatic, they are usually treated aggressively, either by microsurgery and radiotherapy, either by Gamma Knife. These are dangerous tumours with a reserved prognosis mostly depending on the control of the primary cancer disease.
Meningiomas originate in the meninges, the envelopes surrounding the brain. They are often compared to fibromas, and are usually benign although unfortunately not always. Their treatment is essentially surgical resection, sometimes (rarely) followed by postoperative radiotherapy or radiosurgery. Their vital prognosis is usually good but recurrences are possible, and these may require reoperations.
Other brain tumors
Other brain tumors include skull base tumours (vestibular schwannomas aka acoustic neurinomas, pituitary tumours, cordomas) and intraventricular tumours (ependymomas, subependymomas, choroid plexus papillomas). Each of these tumours cause typical symptoms and require specific medical and surgical treatment.