Brain Tumor Surgery

Brain Tumor Surgery

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Brain Tumors

The incidence of primary brain tumors is 6/100,000 per year. Although less common, the incidence of metastatic brain tumors is also thought to be at this level. Lung and breast cancers metastasize to the brain most frequently. Approximately 1/12 of primary brain tumors occur under the age of 15. In adults, 85% of intracranial tumors are located in the supratentorial region. Gliomas, meningiomas and metastases are the most common types. In children, 60% of intracranial tumors are located in the infratentorial region, the most common types being medullablastoma and cerebellar astrocytoma.

The main symptoms and signs of intracranial tumors are headache, nausea, vomiting, loss of strength, impaired consciousness, papillary stasis on fundus examination, and visual acuity.z baby light reaction anomalies and generalized, partial or partial onset and generalized epileptic (epileptic) seizures seen in 30-50% of patients.

Non-contrast and contrast-enhanced CT and MRI examinations are essential in the diagnosis. Depending on the type of tumor, additional tests such as direct radiography, angiography and lumbar puncture may be required. Please visit https://cdn.npistanbul.com/beyin-tumoru for detailed information.

Major intracranial tumors:

ASTROSITOMA and GLIOBLASTOME

These tumors arise from brain astrocytic cells and can be seen in all age groups. It is more common between 40-60 years of age. The male/female ratio is 2/1. Histopathologically, they are divided into 4 stages (Stages 1-4). Malignant (Stage 4) Glioblastoma accounts for 40% of all intracranial tumors. It is most commonly seen around 55 years of age. They are fast growing tumors that cause diffuse infiltration of adjacent brain tissue and peripheral edema.

MENINGIOMAS

They develop from arachnoid membrane cells, the second layer of the cerebral membranes. They are usually located near venous sinuses and in the parasagittal region, in the convexity of the hemisphere. Meningiomas cause compression of adjacent brain tissue. Although they occasionally infiltrate the cranium, most of them are benign. They constitute -20% of all intracranial tumors.

METASTATIC TUMORS

Intracranial metastases occur in 25% of patients with cancer. The most common tumors that metastasize to the brain are bronchial carcinoma, breast carcinoma, kidney and thyroid tumors, gastric and prostate carcinoma, testicular tumors, and malignant melanoma. 50% of intracranial metastases are more than one.

VESTIBULAR SCHWANNOMA

Tumors originating from the VIIIth cranial nerve sheath cells are the most common infratentorial tumors. They constitute 5-10% of all intracranial tumors. They mostly occur in middle age (40-50) and are slightly more common in women. They are benign, slow-growing tumors that grow towards the wedge-shaped area between the brain stem, cerebellum and petrous bone. With the development of the tumor, slowly progressive hearing loss, buzzing and tinnitus, facial paralysis, facial pain and numbness occur.

PITUITARY ADENOMAS

They are benign tumors that develop from the anterior lobe of the pituitary gland (adenohypophysis) and account for 15% of all intracranial tumors. Histopathologically and clinically, they are divided into two main groups as endocrine active (75%) and endocrine inactive (25%).

Clinical findings include headache, visual field and visual acuity changes due to tumor compression of surrounding tissues and effects on the body according to hormonal activity. Unlike other intracranial tumors, sella spot radiography, sella CT and sella MRI with dynamic contrast, neuroendocrine profile, visual field and visual acuity are used in the diagnosis.

Among endocrine active pituitary adenomas, prolactinomas are the most common with 30%. Prolactin is the hormone that provides lactation (milk from the breasts). In case of excessive secretion, infertility (infertility), amenorrhea (inability to menstruate), galactorrhea (abnormal milk from the breasts), and impotence as well as galactorrhea in men. The other endocrine active pituitary adenoma is ACTH-secreting adenoma. The resulting Cushing's syndrome is caused by pituitary microadenoma or hyperplasia in 60% of cases. Clinical findings include grandfather moon face, obesity, purple stretch marks on the abdomen, muscle wasting and weakness, osteoporosis, diabetes mellitus, hypertension, acne, increased hair growth or baldness, susceptibility to infection, and fat accumulation on the back (buffalo hump).

Pituitary apoplexy, a rare condition in pituitary adenomas, is bleeding into the tumor tissue. Severe pituitary insufficiency is seen with sudden and severe headache, rapidly progressive vision loss and paralysis of the eye muscles. If not treated urgently (steroids, emergency surgery), death can result.

Pituitary Gland Tumor

Pituitary gland tumors are usually benign and slow-growing masses. Pituitary gland tumors usually develop in the anterior two-thirds of the pituitary gland. These tumors are classified into two types: "secretory" and "non-secretory". Overproduction of hormones is associated with a "secretory tumor". The types of hormones secreted by the pituitary gland tumor are a factor for further classification of such tumors. For more information please visit https://cdn.npistanbul.com/hipofiz-bezi-tumoru

What is a brain hemorrhage?

A cerebral hemorrhage is when blood leaks out of one or more of the blood vessels supplying the brain, causing the blood supply to stop working. This can happen suddenly and is usually seen in people with high blood pressure. As a result of cerebral hemorrhage, paralysis and stroke may occur in the patient.For detailed information, please visithttps://cdn.npistanbul.com/beyin-kanamasi .

What is Chiari Malformation (Cerebellum Prolapse)?

Chiari Malformation is a condition commonly known as cerebellar prolapse. The cause of the disease is that the lower appendages of the cerebellum sag from the skull cavity and put pressure on the spinal cord. Due to this pressure, deterioration and fluid accumulation occurs in the spinal cord. For more detailed information, please visit https://cdn.npistanbul.com/chiari-malformasyonu-beyincik-sarkmasi.

Vascular Diseases

Cerebrovascular disease (CVD) is a temporary or permanent lesion of an area of the brain caused by ischemia (lack of nutrition) or bleeding.

INTRACEREBRAL HEMATOMA

Intracerebral hematoma (ICH) is bleeding into the brain tissue. 70-80% of cases are caused by hypertension. Aneurysms and arteriovenous malformations (AVM) constitute 25-30% of cases. Clinical findings may include sudden headache due to mass effect, sudden loss of consciousness, vomiting and unilateral strength. In some cases, slow and progressive deterioration in the level of consciousness is observed in 24-48 hours. Diagnostic brain CT shows the location and extent of the hemorrhage and other changes in the brain tissue. Cerebral angiography shows the underlying cause (AVM, aneurysm).

SUBARACHNOID HEMORRHAGE

Brain vessels are located in the subarachnoidal space. Subarachnoid hemorrhage (SAH) occurs when these vessels or aneurysms on these vessels bleed. The frequency is around 9-12/100,000 per year. The severity of symptoms depends on the severity of the bleeding. The patient may collapse with a sudden and severe headache. This is often followed by a brief or prolonged loss of consciousness and/or an epileptic seizure. Nausea and vomiting are almost always present.

The incidence of SAH due to rupture of an intracranial aneurysm is approximately 6-12/100,000 per year. The male/female ratio is 3/2. It is common between 40-60 years of age.

Arteriovenous malformations (AVM) are developmental anomalies of intracranial vessels. There is a direct and pathologic relationship between the arterial and venous systems due to underdevelopment of the cerebral capillary bed. Unilateral and throbbing headache, generalized and focal seizures may develop before or after bleeding. The risk of hemorrhage in AVM is around 2-3% per year, and the mortality rate is around.

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CreatorNP Istanbul Hospital Editorial Board
Updated At05 March 2024
Created At31 August 2020
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