Brain Tumor : Early diagnosis and correct treatment is key for treating -

Brain Tumor can occur at all age groups and early diagnosis and correct treatment is key for treating Brain tumor. World Brain Tumor day dedicated to create awareness about Brain tumors is observed on June 8th.

JUNE 8th is dedicated to create awareness about Brain tumors. Brain tumors can occur at all age groups. In spite of the advances in brain imaging such as MRI SCAN, the diagnosis is still getting delayed often affecting the outcomes. Today, neurosurgeons are well geared up with technology to deal with any kind of tumor in the brain regardless of the location. The technology includes diffusion tensor imaging, cerebral angiography, surgical microscope, endoscope, ultrasonic aspiration, radio frequency bipolar systems, computer assisted neuro navigation ensuring safety as well as gross total removal of tumors. Awake brain surgery is another specialised procedure to deal with tumors located in eloquent areas controlling speech, movements of hand or leg. Complete removal where ever possible has proven to have better outcomes. However, time to diagnosis is so delayed that these tumors grow to a mammoth size posing serious problems.

It is commonly known that progressive headache and vomiting generally gives suspicion of a brain tumor. However, many subtle symptoms are often missed. Young children and elderly are a special challenge as one group can’t express and the other is considered due to age. Irritability, excessive crying, not feeding well, enlarging head, sudden behavioural change, decreased scholastic performance, inactivity, frequent falls while playing, difficulty in reading, neck tilt must raise an alarm in young children. These observations are often made by mothers and teachers and should be given importance. Off course a child having headache, seizure or any neurological problem should never be neglected.

Similarly in adults, unilateral visual deterioration, hearing loss, loss of smell should not be ignored. In addition, rapid change in behaviour, memory, speech, higher brain faculties should be investigated. They should not be attributed to the age until proved otherwise. These are very minor differences indicating the brain dysfunction.

A 65 year old gentleman came to Brains Hospital with difficulty in handling numbers and making calculations for over 3 months. He was a retired Principal of a college, hence he could easily identify the difficulty. There was no other symptom. The difficulty rather progressed slowly, making even simple calculations difficult. Yet he too considered this as part of his ageing, but it was a surprise to the family and friends who knew him closely. Hence, he was compelled to come to hospital for an evaluation. Detailed neurological testing had shown typical difficulty in performing calculations. He was diagnosed with Classical Acalculia. MRI Scan of the brain revealed a tumor involving the junction of left temporal and parietal lobes. He had to be convinced for the need of surgery. Using micro surgical technique, the localised tumor was removed completely. This tumor had disrupted the connections between the parietal and temporal parts in the braincausing the calculation difficulty selectively.

Parietal lobe of the brain is the seat of calculations. It has connections to temporal lobe to retrieve information from memory, and occipital lobe to read and identify numbers.Parietal lobes are major centres in the brain that receives and processes all the sensory information. In addition, they provide very special faculties called higher cortical sensations, interpreting the complex sensory experiences, their cognition, information processing, spatial orientation, body schema, reading and computation. Left parietal brain particularly deals with computation and mathematics. There are specific areas and association areas that interact with the surrounding networks, ultimately dealing with numbers, their forward, backward linear computations, addition, subtraction, division and multiplication. All these functions have selective designated areas but work together to accomplish the task.

The tumor being located precisely in this area, interrupting the information processing lead to this unique problem called “Acalculia”, meaning difficulty in performing calculations. This difficulty can manifest in many different combinations. It is important to recognise them by simple observation of the individual abilities in dayto day life. Here fortunately the problem was noticed quite early and hence the tumor could be diagnosed early and removed totally before other abilities were damaged. Such timely removals by Micro-neurosurgery can make a huge difference to the longevity as well as to the quality of life.