Brain Tumors

BRAIN TUMORS
Content
 1. Brain & Brain Tumor
 2. Types and Grades of Tumors
 3. Risk Factors
 4. Signs and Symptoms
 5. Diagnosis
 6. Treatment & Supportive Care
Brain tumour : Defination
known as an intracranial tumor
 is an abnormal mass of tissue in which cells
grow and multiply uncontrollably, seemingly

unchecked by the mechanisms that control
normal cells
 Tumors of the nervous system may arise
from
 Cells of the coverings – meninges, bone,
subcutaneous
 Cells intrinsic to the brain
 Other cell populations within the skull
 Metastases (spread from elsewhere in the
body )
Classification
 Based on source
 Primary – originates from CNS
 Secondary / metastatic – originates
elsewhere in body
 Based on location
 Supratentorial -in adults

 Infratentorial m/c in pediatric age group
Tissue of origin
 Glial :
 Meningial :
 Embryonal;
 Mixed
 Vascular
 Bony origin
Benign brain tumors
 Benign brain tumors do not contain cancer
cells
• Usually, benign tumors can be removed
and the rarely grow back.
• Benign brain tumors have an obvious
border or edge.
• They don't spread to other parts of the
body
• They don't invade tissues around them,
however, benign tumors can press on
sensitive area of brain and can cause
serious neurological deficits.
• Unlike benign tumor of other parts of the
body, benign tumour of the brain are
sometimes life threatening
• with time benign brain tumours can
become malignant.
Malignant brain tumors
 contain cancer cells
• More serious and often are threat to life
• Rapid Growth
• Invade or crowd nearby healthy brain tissue
• Cancer cell may spread to other parts of the
brain or to the spinal cord
• rarely spread to other part of a body
Metastatic Brain Tumor
 Originates from malignancies outside of the
CNS and spread to the brain, typically
through arterial circulation.
 Approx. 25% of individual with systemic
cancer develop metastatic brain tumor

 80% in cerebral hemisphere and 20% in the
posterior fossa.
 1/3rd of brain metastases orginate in
Lungs→ Breast→ Skin→ GI tract→ Kidney

 Frontal lobe is the most common site
Grades of Tumors
General Features
10% of all tumors.

 Commonest solid cancers in children.(2nd to
Leuk for all malignancies)

 Age: double peak 1st& 6th decade
 Adults - 70% supratentorial
 Children - 70% infratentorial
RISK FACTOR
 A risk factor is something that may increase the
chance of getting a disease.
 Ionizing Radiations : especially from high dose
x-rays and other sources can cause cell
damage that leads to a tumor
 most common types are meningioma or
glioma.
 Family History : It is rare for brain tumors to
run in a family. only a very few number of
families have several member with brain tumors
Most common primary brain tumors
Gliomas (50.4%)
 Meningiomas (20.8%)
 Pituitary adenomas (15%)
 Nerve sheath tumors (8%)
Signs and symptoms
 Depend on tumor size, type and location.
 Symptoms may be caused when a tumor presses
on the nerve or harms the part of the brain
 Most common symptoms of brain tumors
• Headaches
• Nausea and vomiting
• Changes in speech, vision, or hearing
• Problems balancing or walking
• Changes in mood, personality, or ability to
concentrate
Headache
presenting symptom in 30 % of the cases &
devlops during the course of the disease in 70%
of the cases
1. The headache that interrupts sleep or is worse
on waking
2. The headache that is elicited by postural
changes, coughing, or exercise
3. The headache of recent onset that is more
severe or of a different type than usual
4. The headache associated with nausea and
vomiting, papilledema, or focal neurological signs
Seizure
 Presenting symptom in 1/3rd of cases and is
present in 50%-70% of cases at some stage of
the disease.
 Approx 10%-20% adults with new onset
seizure activity have brain tumors.

 Seizures produce by brain tumor in
• Frontal Lobe (59%) 

• Parietal Lobe (42%) 
• Temporal Lobe (35%)
• Occipital Lobe (33%)
FOCAL NEUROLOGIC DEFICITS
 paralysis on one side of the body, reduced

mental capacity, vision loss
 Aphasia & Gait Difficulties
 cranial nerve palsy
 Papilledema
Diagnosis
 A clinical diagnosis consist of information the
physician gathers during a comprehensive
examination.
 Medical History including the specific nature
of S&S 
 Neurological Examination
 Opthalmic examination –
Radiological Diagnosis
 Noninvasive techniques
 Provide accurate anatomical and functional
analysis of intracranial structures.

 MRI is the imaging procedure of choice
 MRI is superior to CT in detecting &
localizing tumor as well as evaluating edema,

hydrocephalus or hemorrhage.
Glioblastoma
Glioblastoma
 Meningioma
 Biopsy
 Surgical biopsy is performed to obtain tumor
tissue as part of tumor resection or as a

separate diagnostic procedure.
 Stereotactic biopsy is a computer-directed
needle biopsy.
 Perimetry
 Electroencephalography (EEG)
 Audiometry and vestibular testing
 Endocrine testing
TREATMENT
The ultimate goal of tumor management are
to improve quality of life and extend survival
 Treatment techniques are determined by
histological type, location, grade, and size of

tumor; age of onset; and medical history of
the patient.
Four Type of Treatment
1. Surgery
2. Chemotherapy
3. Radiation Therapy
4. Stereotactic Radiosurgery
SUPPORTIVE CARE:
 Steroids :
• Most patient with brain tumors need steroids
to help relieve swelling of the brain. Eg,
Dexamethasone may be used before and
after treatment to reduce cerebral edema.
• Anticonvulsant medicine:
Brain tumors can cause seizure.
Anticonvulsant are used to prevent and
control seizures.
 Further reading
 Harrison's Principles of Internal Medicine
21th edition
 Clinical Neurology 8th edition
THANK YOU!

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BRAIN TUMORS

grow and multiply uncontrollably, seemingly

 Supratentorial -in adults

cancer develop metastatic brain tumor

Lungs→ Breast→ Skin→ GI tract→ Kidney

10% of all tumors.

Leuk for all malignancies)

seizure activity have brain tumors.

• Frontal Lobe (59%) 

 paralysis on one side of the body, reduced

analysis of intracranial structures.

localizing tumor as well as evaluating edema,

tissue as part of tumor resection or as a

histological type, location, grade, and size of

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