Brain Tumor: an abnormal growth that occurs due to uncontrolled cell multiplication often classified by their origin or how they grow

What are Tumors?

A brain tumor is an abnormal growth that occurs due to uncontrolled cell multiplication. The presence of brain tumors can affect the normal structure and activities of the brain in many ways, including increasing pressure on the brain or skull, blocking structures, or damaging nerves and tissue.

Brain tumors are most often classified by their origin or how they grow. Regardless of classification, any brain tumor has the potential to become life-threatening if left untreated.

When classifying by origin, the terms used are Primary and Metastatic.

Primary tumors are those located at the site where the tumor began to grow or originated, meaning primary brain tumors rarely spread to other areas. Primary brain tumors can be further classified as glial tumors and non-glial tumors. Glial tumors are also called gliomas.

Metastatic, or secondary, tumors are those that have spread to other parts of body from the original tumor site.

When classifying by rate of growth, the terms used are Benign and Malignant.

Malignant, or cancerous, tumors tend to keep growing despite treatment and can become life threatening.
Benign, or non-cancerous, tumors tend to grow slower than malignant tumors. Depending on their location in the brain, benign tumors can often be cured by treatment or removal, but they can still cause serious issues if left untreated.

Causes of Brain Tumors

A tumor is an abnormal growth caused by abnormal cell multiplication that does not serve any physiological function. Cell division is regulated by the tumor suppressor genes. These genes also help to repair any damage caused to the DNA. Tumor suppressor genes are constantly at war against the cancer-causing genes called oncogenes. When tumor suppressor genes fail to function properly due to mutations that affect protein encoding, unregulated cell division and growth can occur and cause the development of a tumor.

The body's natural defense system should optimally detect the abnormal cells and kill them. But tumors may produce substances that obstruct the immune system from recognizing the abnormality of tumor cells and eventually the tumor cells may overpower all internal and external checks to their growth.

Certain types of radiation exposure and genetic disorders have been linked with brain tumors. Although some environmental factors are suspected of contributing to the development of tumors, doctors do not know many of the risk factors of many types of tumors yet.

Symptoms of Brain Tumors:

There are many different kinds of brain tumors, so the symptoms will vary depending on the specific type, size, and location of the tumor. Some of the more common symptoms of brain tumors include:

Headaches are one of the most common symptoms of brain tumors. Specifically, headaches upon waking, non-migraine headaches accompanied by vomiting, headaches accompanied by double vision, numbness, or weakness, and headaches accompanied by neck pain.

• Seizure
• Changes in personality or behavior
• Changes in mental function, which could include memory loss, confusion, speech difficulty, or impaired concentration or reasoning
• Increase in sleeping time
• Gradual loss of movement or sensation in arms or legs, balance problems
• Difficulties with speech and comprehension
  visual problems or changes

Diagnosis of Tumors

Your doctor will perform a neurological exam to test your mental and physical functioning. During this exam, faculties including your eyes, ears, nose, muscles, sensations, balance, coordination, mental state and memory may be tested. If the results are abnormal, imaging studies may be used to give a clearer image of the brain. Tests performed may include magnetic resonance imaging, or MRI, computed tomography, or CT, and biopsy to examine a sample of tissue from the tumor.

Treatment Options for Brain Tumors

If the tumor is static or growing slowly and does not cause pressure on the adjacent brain tissue, conservative therapy may be utilized. Patients are closely monitored on a regular basis with MRI scans and if the tumor grows or the patient develops symptoms related to it, treatment is started.

If the tumor is growing fast, or is life threatening, definitive therapy may be utilized. This can include more aggressive treatment techniques such as surgery, radiation therapy, or chemotherapy. Biopsies and surgical treatment of brain tumors generally require a craniotomy.

All information provided on this website is for information purposes only. Please see a healthcare professional for medical advice. If you are seeking this information in an emergency situation, please call 911 and seek emergency help.

Chiari Malformation: when part of skull is deformed or too small, which puts pressure on brain and brainstem.

What is a Chiari Malformation?

A Chiari Malformation occurs when the part of the skull that contains the cerebellum is deformed or too small, which puts pressure on the brain and brainstem, forcing it past the opening to the spinal canal. The pressure on the cerebellum can cause signs of neurological problems. Forcing the cerebellum into the upper spinal canal can also disrupt the flow of cerebrospinal fluid, which protects the brain and spinal cord. This can interfere with the signals normally transmitted between the brain and the body. It can also cause spinal fluid to build up in the spinal cord or brain.

What causes Chiari Malformations?

The cause of Chiari malformation is not currently known, but it may be due to problems during fetal development, like exposure to hazardous substances. It may also run in families. There are four types of Chiari malformation:

TYPE I: This is the adult form of chiari malformation, and the most common of the four types. It develops as the brain and skull grow, so symptoms may not appear until adulthood or adolescence. This type does not involve the brainstem.

TYPE II: This type is congenital and is the most common pediatric form of chiari malformation. This type forces the cerebellum and brainstem into the upper spinal canal. Type ii is often seen in infants born with spina bifida, which causes part of the spinal cord and its surrounding structures to form outside the body, often causing complete or partial paralysis. This type is sometimes associated with hydrocephalus, a condition in which too much cerebral spinal fluid is in the brain. This puts further pressure on the inside of the skull, often creating a larger-than-usual appearance.

TYPE III: This type occurs when, in addition to the cerebellum and brain stem being pushed through the spinal canal opening, part of the fourth ventricle, the part of the brain that circulates cerebral spinal fluid and connects upper parts of the brain, is pushed through the opening to the spinal canal. In this type, the back of the brain can protrude out of the back of the skull. This type is very serious and can cause severe neurological defects.

TYPE IV: This type of chiari malformation occurs when the cerebellum fails to develop normally. The cerebellum may have parts missing or be found further down the spinal canal.

Symptoms and Diagnosis

Symptoms of Chiari malformation Type I typically include headaches that are made worse by coughing, straining or sneezing. Neck pain that sometimes goes down the shoulders and problems with gait and balance also may occur. A patient with Chiari malformation Type I may also have numbness and tingling of the feet and hands, as well as problems with fine motor skills. Slurred speech, vision problems, difficulty swallowing and dizziness are also symptoms. Sometimes, tinnitus, bladder control problems, and sleep apnea can also occur, as well as chest pain and spinal curvature.

In a patient with Chiari malformation Type II, symptoms related to spina bifida may be present. In this type, more tissue is forced into the spinal canal than in Type I.

In Types II, III, and IV, the diagnosis may be made when the patient is born, as the congenital defects will be obvious from birth. A patient with Chiari malformation Type I may not have any symptoms until adolescence or adulthood, so the physician will go over the patient's medical history, asking about developmental milestones and family medical problems. A physical exam will follow, during which the circumference of the head may be measured, and the back may be examined. Diagnostic tests like an MRI or a CT scan can confirm the diagnosis.

How are Chiari Malformations treated?

If the patient is without symptoms or the symptoms are not severe, the physician may prescribe observation and medication. However, to treat severe Chiari malformation, surgery is required to stop the progression of anatomical changes in the brain and spinal canal and to ease symptoms. Surgeries are usually decompressive in nature and may include a spinal laminectomy or a posterior fossa craniectomy. More than one surgery may be needed to treat Chiari malformation.

Risks and benefits

Failure to take preventive measures for any spinal condition may result in a further aggravated condition. Surgical measures for advanced cases may give relief from extremity pain. The risks involved with surgery are common - infection, blood loss, non-union, damage to nerves and spine - and some specific to your treatment. This material is intended to give the patient an overview of surgical procedures and treatments and is not intended to replace the advice and guidance of a physician. Always consult with your doctor about the particular risks and benefits of your treatment.

Meningioma: type of brain tumor, often benign. Some symptoms: headaches, seizures, vision and hearing problems.

What is Meningioma?

Meninges are the three membrane layers that envelop the brain and spinal cord. The (outermost) of these thin layers is the dura mater, the second layer is the arachnoid, and the third layer is the pia mater.

A meningioma is a primary intracranial tumor of the meninges. Primary means that this type of brain tumor develops and stays in the brain. Meningiomas are classified into three grades. Meningiomas are also usually benign, meaning that they grow slowly, but if they are not discovered on a timely basis, they can interfere with the brain's normal functioning. In certain locations, they can be severely disabling and even life threatening if they become large enough. Usually patients develop only a single meningioma; however, several meningiomas may simultaneously grow in other parts of the brain or spinal cord.

Grade 1 is Benign Meningioma, which has the lowest rate of growth and recurrence risk. Grade 2 is Atypical Meningioma, which is more aggressive in terms of growth and recurrence risk. Grade 3 is Malignant (Anaplastic) Meningioma, which has the most aggressive rate of grow and highest risk of recurring.

Cause of Meningiomas

A tumor is an abnormal growth caused by abnormal cell multiplication that does not serve any physiological function. Cell division is regulated by the tumor suppressor genes. These genes also help to repair any damage caused to the DNA. Tumor suppressor genes are constantly at war against the cancer-causing genes called oncogenes. When tumor suppressor genes fail to function properly due to mutations that affect protein encoding, unregulated cell division and growth can occur and cause the development of a tumor.

The body's natural defense system should optimally detect the abnormal cells and kill them. But tumors may produce substances that obstruct the immune system from recognizing the abnormality of tumor cells and eventually the tumor cells may overpower all internal and external checks to their growth.

Certain types of radiation exposure and genetic disorders have been linked with meningiomas. Although some environmental factors are suspected of contributing to the development of tumors, doctors do not know many of the risk factors of many types of tumors yet.

Symptoms of Meningiomas

The symptoms of meningiomas usually become noticeable only when the tumor has grown quite large. Symptoms do not show up in the early stages due to the benign nature of this tumor. Some meningiomas may never exhibit symptoms during a patient's lifetime. Symptoms will vary depending on the size and location of the tumor.

Some common symptoms of meningiomas may include:

• headaches
• seizures
• changes in behavior or personality
• progressive focal neurologic deficit
• confusion and lack of judgment
• nausea and vomiting
• changes in vision

Diagnosis of Meningioma

Since meningiomas may not exhibit any symptoms, they might be detected unexpectedly when a patient has a brain scan for unrelated symptoms.

If a person is suspected of having a meningioma, a neurological exam will be done. This involves checking the function of eyes, ears, nose, and muscles. Sensation, balance and coordination are also tested. Mental state and memory are also assessed.

Diagnostic imaging tests may be ordered, including computerized tomography, or CT, scans or magnetic resonance imaging, or MRI, scans. The results from these imaging studies can help to determine the size, location, and type of tumor. The diagnosis may also be confirmed by examining a tissue sample taken from the tumor in a procedure called a biopsy.

Treatment Options

Observation and less invasive treatment options may be chosen if:

• the symptoms are mild with little or no swelling
• the patient is older and symptoms are increasing slowly
• the other treatment options carry significant risks for the patient
• the symptoms have little effect on the patient's quality of life

Surgery is generally the standard treatment option for meningiomas. Surgery is often successful in treating meningiomas because they are a benign tumor with defined boundaries.

Surgery involves removal of the affected cells. Surgery is scheduled soon after the initial diagnosis. Surgery may not be the only treatment. It is often complemented with other techniques, like radiation therapy if complete removal of all affected cells is not possible or if the tumor is recurrent.