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Primary tumours of the brain comprise about 5 per cent of
the human cancers in adults and 20 per cent of the childhood cancers. The peak
age of developing primary tumour of the brain is 50 to 60 years in adults and 5
to 10 years in children, however it may occur at any age. A primary tumour of
the brain may be benign or malignant in character but even a benign tumour of
the brain has devastating effects because the skull cannot expand to
accommodate the growing tumour mass. Some tumours of the brain such as
neurofibroma, haemangioblastoma, craniopharyngioma and retinoblastoma have a
familial tendency. Risk factors of the primary brain tumours include viral
infections, tuberous sclerosis, cranial irradiation and environmental factors.
Certain benign tumours of the brain may transform into a malignant tumour.
The brain tumours usually remain asymptomatic (silent) in
early stages of the disease. Symptoms start appearing as the tumour grows in
size. The brain tumours may present with symptoms related to the focal cerebral
disturbances and the generalised symptoms. The cerebral symptoms vary depending
on location of the tumour.
Common symptoms of the brain tumours include headache,
nausea, vomiting, malaise, convulsions and the focal neurological deficit.
There may be subtle changes in the mental functions including personality,
intelligence and memory. The raised intracranial pressure may lead to headache
(early morning headache), vomiting, papilloedema, hypertension, bradycardia and
decreased level of consciousness.
The most common symptom of a spinal cord tumour is pain
that may be localised in the back or radiating to the extremities. The pain
gets characteristically aggravated on coughing or straining. There may be
spinal dysfunctions including the motor deficit, paraesthesia and numbness in the
legs due to direct compression of the spinal cord.
Malignant tumours of the brain usually do not metastasise
to the extracerebral sites but metastases to other parts of the brain may
occur. Procedures used in diagnosis and evaluation of the brain & the
spinal cord tumours include X-rays, CT scan, MRI, EEG, cerebral angiography,
spinal tap, CSF cytology pneumoencephalography and biopsy.
The brain and the spinal cord tumours are classified
according to the histopathological grade of the tumour and the type of cells of
their origin. Approximately 50 per cent of the primary intracranial malignant
tumours are gliomas (astrocytomas). In adults, the glioma is usually located in
the cerebral hemispheres, whereas in children the glioma is usually located in
the cerebellum and the brain stem. Other primary intracranial malignant tumours
include oligodendroglioma, medulloblastoma, ependymoma, and microglioma
(cerebral lymphoma). Oligodendroglioma and cerebral lymphoma are usually
located in the cerebral hemispheres and occur in adults, whereas
medulloblastoma and ependymoma are usually located in the posterior fossa and
occur in children. Benign intracranial tumours include meningioma,
neurofibroma, craniopharyngioma, pituitary adenoma and colloid cyst.
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Brain & Spinal Cord Tumours