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BRAIN ATTACK:

Know About the Treatment Options for Brain Tumor

By Dr. Arun Saroha in Neurosurgery , Neurosciences

Nov 09 , 2020 | 2 min read

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All tumours present inside the cranium are classified as brain tumours. Tumors can manifest inside the brain or travel through the lymphatic system in the blood vessels. A brain tumour-like other tumours is a life-threatening disease.

The causes, brain tumour symptoms and why it occurs are still unknown. There are certain inherited conditions like the Von Hippel-Lindau Syndrome, Li-Fraumeni Syndrome, Neurofibromatosis and Turcot Syndrome that increase the risk of brain tumours.

What are the Treatment Options for Brain Tumor?

When a person is diagnosed with a brain tumour, a group of specialists including Neurologists, Radiologists and Neurosurgeons assess the extent of a tumour and derive the best possible treatment options. The brain tumour treatment options largely depend on various factors such as –

  • Location of a tumour
  • Size of a tumour
  • Tumor stage
  • Type of tumours

Neurosurgery

Surgery is often the preferred treatment option when it comes to curing a brain tumour. One should consult the best neuro hospitals if the patient is having a tumour in the brain. There are several techniques employed during surgery including IGS (Image Guided Surgery) which accurately maps out the location of a tumour.

However, before the surgery, depending on the location of a tumour, the doctor will determine whether it is operable or inoperable.

Operable Tumor

A tumour which can be surgically removed with minimal risk of brain damage is known as an operable tumour.

Inoperable Tumor

If a tumour is located in a place near a vital area or structure and is inaccessible by the surgeon; then this tumour is termed as inoperable. Tumors located in the brain stem and thalamus is two such examples. But we do a stereotactic biopsy in thalamic tumours.

What Type of Surgery Is Recommended?

The common types of surgery for brain tumours are:

Biopsy (Open or Needle Biopsy / Stereotactic Biopsy)

A biopsy is a surgical procedure that involves taking a sample in case of not a definite diagnosis and inoperable states of the tumour tissue. It is used to determine the exact type of tumour for further treatment. The sample tissue diagnosis can further be used to determine if radiation therapy/chemotherapy / Radiosurgery will be useful.

What Happens During a Biopsy?

A biopsy is carried out in the following steps:

  • Patient with a brain tumour will undergo an MRI or CT Scan to determine the exact location of tumour
  • A dose of general anaesthesia is given to the patient
  • A small ‘burr hole’ is drilled on the skull by the neurosurgeon
  • The surgeon then passes a needle through the hole to take a sample of the tumour
  • Hole is closed using stitches and patient is given steroids to help with swelling

Craniotomy

A craniotomy is the most common type of surgery for a brain tumour. The procedure involves shaving a portion of the head, making an incision in the scalp then using an operating drill to remove a portion of the skull where a tumour is located. This enables the surgeon to remove as much tumour as possible. Once a tumour is removed, the portion of the skull which was removed is replaced, fixed with titanium plates and screws and then the scalp is stitched back.

Awake craniotomy

  • In some cases, if a patient is undergoing awake craniotomy, they will be awake to allow the neurosurgeon to map where the functions of the brain are located
  • The brain does not feel pain, and in case of an awake craniotomy the patient might be able to feel only the pulling of a tumour
  • Neurosurgeon will remove as much tumour as possible without any brain damage
  • When an entire tumour is removed, it is known as ‘total resection.
  • When only a part is removed, it is known as ‘debulking’
  • The bone flap which is removed is replaced, and the wound is closed using stitches