The brain and spinal cord are surrounded by a protective membrane. Here, cerebrospinal fluid is present. The brain is protected by the skull and the spinal cord is protected by the spine. In other words, the cerebrospinal cord, the surrounding membrane and bone form a whole structure. It connects the brain stem with the cerebrospinal cord. Communication between the brain and spinal cord occurs through a hole in the back of the skull. Very generally, the brain is divided into anterior (frontal), lateral (parietal, temporal) and posterior (occipital) sections. At the back, the cerebellum is responsible for the balance and harmony of our body.
Brain tumor develops when cells become abnormal, multiply uncontrollably and become a mass. As a result of its irregular growth and development, it causes pressure on the brain, increased pressure in the skull and its negative findings. Although heredity, radiation, chemical factors and environmental pollution are thought to be important factors, the cause has not been fully revealed.
Although there are difficulties in the diagnosis and treatment of brain tumor; In parallel with the rapid technological developments in recent years, this situation has begun to be overcome. It is one of the most common types of cancer. Those that have developed in the brain itself (glial tumors) and its surrounding membrane (menengiomas) are considered primary brain tumors, and those that have spread from other organs (metastases) are considered secondary brain tumors. Secondary tumors are more common. Apart from these, there are those that develop from nerves (neurinoma) and those that develop from brain vessels (hemangiomas).
Benign brain tumors, slow growing, less likely to recur, mostly do not spread to surrounding tissues. The borders with the surrounding tissues are clear. This situation provides convenience in the surgery (removal process) of the tumor. Since it is highly likely that they will be removed completely or almost completely, the results after the operation are satisfactory. However, sometimes benign tumors can settle in vital areas of the brain. In such a case, the results may not be good due to the placement characteristics.
Malignant brain tumors are rapidly growing tumors that spread and damage the surrounding tissues. It is not possible to clearly distinguish its borders. They cannot be completely removed by surgery. However, the mass effect of the tumor is reduced. Surgery has a positive effect on life expectancy and quality. The probability of recurrence is high. There are types that give a chance of survival from 5-6 months to 5-6 years postoperatively.
Some brain tumors according to their pathological diagnosis:
Astrocytomas; They grow slowly and spread to surrounding tissues. The relatively benign ones tend to occur in children and young adults. Malignant types are more common in the age of 40-60 years. It is generally seen in middle age. It is more common in men. Glioblastoma Multiforme can be evaluated as a malignant astrocytoma. It is one of the most common brain tumors. It shows rapid progress. It is most common between 55-60 years of age. Ependymomas are common in children and teenagers. They are usually well circumscribed and benign. It may spread to surrounding tissues. They are sensitive to radiotherapy. It is often recommended after the operation. Oligodendrogliomas usually grow slowly and are most common between the ages of 25-45. The most common symptoms are epileptic seizures. They may be considered benign, but they have growth rates and potential for malignant development.
Medulloblastoma is one of the most common childhood malignancies. It is most common around the age of 5 years. Localization is common in males and in the posterior head region. It shows high sensitivity to radiotherapy. It should be applied following surgery. Meningioma are slow growing, benign tumors. Healing can be achieved with their complete removal. A good surgical intervention is the most effective form of treatment. It is more common in women aged 40-50 years. Metastatic Tumors are formed by the spread of tumors in other structures to the brain and are malignant. The most common are lung cancer, breast cancer, and malignant melanoma (skin cancer). Multiple dissemination is seen in the majority of patients. In such cases, surgery is risky. Radiotherapy is recommended. The most positive results are obtained from surgery and radiotherapy applied afterwards.
Headache, nausea and vomiting occur due to increased intracranial pressure. Dizziness and epileptic seizures may also accompany this condition. Nausea, vomiting, slowing of the pulse, visual disturbances, and mental changes may also be present.
Loss of strength or even paralysis can be seen depending on the area of the tumor. The changes in reflexes are remarkable.
Different findings occur according to the regions of the brain. tumors in the frontal region cause personality changes; Those in the parietal region cause speech disorders, those in the occipital region cause visual disturbances, those in the temporal region cause smell and hearing disorders and more intense seizures.
Headache, epileptic seizures, frequent fainting, personality changes, changes in consciousness, vomiting, menstrual irregularity, milk coming from the breast, visual disturbances (double vision, blurred vision, decreased vision, etc.), numbness in the arms or feet Findings such as weakness, even paralysis, balance disorder, facial paralysis, hearing loss, decreased sense of smell, speech disorder (speech difficulty, wrong word pronunciation), deterioration in some abilities (mathematical operations and handwriting, etc.) occur. It is necessary to be careful and consult a doctor for headaches that occur in different forms and cannot be relieved by medication, and those who have epileptic seizures.
Diagnosis of brain tumors is made by blood and cerebrospinal fluid examination, fundus examination and imaging methods. EEG and Direct X-rays may also be helpful in diagnosis in some cases. As advanced imaging methods; Cerebral angiography, Computerized Brain Tomography (BBT), Magnetic Resonance (MR), Positron Emission Tomography (PET) and Single Photon Emission Computerized Tomography (SPECT) are used. CT and MRI are used most frequently in routine practice.
Depending on the growth rate of the tumor, it can sometimes be a long time between the appearance of symptoms and diagnosis and the beginning of the tumor growth. Early diagnosis is very important in terms of planning the treatment of the patient and achieving positive results. Treatment becomes difficult in a delayed and large tumor. The risk of life threatening increases.
Although there are difficulties in its treatment, successful results can be achieved with the use of surgery, chemotherapy and radiotherapy alone or in combination. The histopathological type, location and size of the tumor affect the success of the surgical intervention. Microsurgery is used in the treatment of brain tumors.
