Brain Tumours-

misconceptions and reality

Dr. Abrar Ahad Wani
MS, MCh ( SGPGI )
Assist. Professor
Department of Neurosurgery
Sher-i-Kashmir Institute of Medical Sciences
Misconceptions
1. Brain tumour = Brain cancer
2. Treatment is not available locally

3. Everybody with brain tumour is going to

die soon
 Background
 The brain is the center
of thoughts, emotions,
memory and speech.
 Brain also control
muscle movements
and interpretation of
sensory information
(sight, sound, touch,
taste, pain etc)
Misconception 1
Brain tumour = Brain cancer
What is brain tumour ?
 A brain tumor is a mass of unnecessary,
and abnormal, cells growing in the
brain.
 Tumors may be benign, malignant, arise
from within the brain, its coverings, or
metastasize from another location in the
body
Neurologic Diagnosis
 Where is it?
 Signs and Symptoms
 What is it ?
Symptoms
 Headache
 Nausea/Vomiting
 Change in level of consciousness
 Weakness of any limb
Types of Tumors
 Benign( non cancerous)
 Meningeal - meningioma
 Nerve lining - schwanoma
 Pituitary - adenoma
 Bone/Cartilage – chondroma, chondrosarcoma,
 Malignant (cancer)
 Primary CNS – astrocytoma, oligodendroglioma
 Metastatic
Incidence
 A study conducted in USA
 Prevalence (primary)
 benign - 100/100,000
 malignant - 30/100,000
Meningiomas
 25.7% of primary
brain tumors
 Most common tumor

in ages:35-44
 Hemispheric
 Headache, seizure, focal neurologic deficit
 Skull base
 Cranial nerve involvement
Meningioma -sphenoid
Meningioma - tuberculum
Pituitary adenoma
 6.2%
 most common in age 20-34
 endocrine secreting
 prolactin
 growth hormone
 ACTH
 non-secreting
Pituitary adenoma
Nerve sheath tumors
 6.9%
 Vestibular schwannoma/acoustic neuroma
 Hearing loss
 Neurofibromatosis Type II
Vestibular Schwannoma
Glioblastoma- cancer
Glioblastoma - cancer
 23% of primary brain tumors
 most common age 45 - 64
 Grade III/III or IV/IV
 Malignant astrocytoma
 Invasive
Statistics of brain cancer
 Second most common malignancy of
childhood, most common solid tumor
 Second leading cause of cancer related
deaths in males age 20-40
 Fifth leading cause of cancer related deaths
in women age 20-40
 Misconception 2

 There is no treatment?
Is treatment not available locally ?
Treatment – mainly surgical
 Conventional craniotomy \ craniectomy
 Newer modalities:

Trans- nasal removal of tumours

Stereotactic biopsy
Conventional craniotomy\craniectomy
Frontal glioma- craniotomy
Medulloblastoma, hemangioblastoma-
craniectomy and tumour decompression
Trans- nasal approach

 Pituitary adenoma
Stereotaxy- for small deep lesions
Surgery is not the end of treatment

 Conventional radiotherapy
 Radiosurgery
 Chemotherapy
Everybody with brain tumour is going
to die soon- misconception 3
 Benign tuours : if tumour is completely
excised most have normal life expectancy
 Malignant tumour
 Grade IV(cancer): mean age 9-12 months
 Grade III : 2 years
 Grade II : 3-5 years
 Grade I : 10-20 years