Signs of brain tumor you should know

Signs of brain tumor you should know; what are the new treatment approaches?

Brain tumor can affect any age, right from infancy all the way up to the elderly. When a brain tumor occurs the symptoms and signs depend on the age, location and the type of tumor. In adults, brain tumor is usually present with headaches that are progressively increasing usually in the early mornings, associated with vomiting, not responding to usual treatments. Eventually this headache will progress into other neurological problems like double vision, impaired vision, weakness or imbalance of the limbs.

These tumors can also produce fits or convulsions. Whenever a convulsion occurs in a person after 25 years for the first time, it is known as late onset seizures and this needs to be investigated for the underlying structural disease. In addition, when a tumor is occupying and exerting pressure over specific areas of brain can manifest with disturbance of speech, motor skills, walking ability and balance. Depending upon the nature of the tumor the symptoms can progress slowly or rapidly.

Very young children often cannot complain of symptoms but may present as seizures with neurological deficits, progressive intellectual deterioration, excessive crying , lack of playfulness and dullness. At times, sometimes neck tilt indicates double vision or impaired vision or posterior fossa tumors. When a child complains of headache it should be taken seriously and investigated. Usually the subtle changes are observed either by the mother or by the teachers. It is always better to investigate aggressively to exclude the tumor rather than ignoring the symptoms till it becomes critical.

The new treatment approaches:

When in suspicion of brain tumor MRI Scan is diagnostic. In the recent years MR Tractography or DTI (Diffusion Tensor Imaging) can clearly depict the displacement of the nerve fibres in the brain by the tumor. This information is highly useful to the surgeons to plan the surgical approach. In addition, functional MRI can help to identify the eloquent areas of the brain in relation to the tumor. During the surgery, we use microscope, endoscope, neuro-navigation, ultrasonic surgical aspirator and fluorescent agents to achieve maximum possible removal of the tumor and also to distinguish the normal brain from the tumor during surgery.

Navigation guides us through the different areas of the tumor and helps to assess the extent of resection in real time. Fluorescence selectively gives a different colour to the tumor, thus helping surgeons to remove it completely without encroaching on to the normal brain. Whenever the tumor is outside the brain total removal is achieved very easily. When the tumor is deep inside the brain, we need all these technologies to remove the tumor and also to preserve the normal brain.

Off late we are resorting more to the awake brain surgery to deal with the tumors located in vital areas. With the assistance of special analgesia the tumors are removed while the patient is conscious and interacting with the surgeon throughout the surgery. This is the surest way of preserving or not damaging the special eloquent areas concerned with speach, movement of hands or legs, hearing, vision, etc. This technique allows us to go for radical removal of brain tumors with total confidence.

In fact total removal of the tumors is directly related to the long term cure . All of them require post-operative anti- seizure medication and regular follow up for at least five years. If the tumor is malignant, supplementary radiotherapy and chemotherapy will be instituted as soon as possible. Future research is more into gene editing to either prevent their occurrence or to modify the biological behaviour. Research on Tumour stem cells is also promising in eradicating the malignancy in the body. At the same time with Nano technology many targeted therapies are in the verge of becoming a reality .