Brain cancer can interfere with normal brain functions such as speech, movement, thoughts, feelings, memory, vision, and hearing. It is a disease of the brain in which abnormal, cancerous cells grow in the brain tissues. Typically, brain cancer is a developed form of a brain tumour. Primary brain cancer or a brain tumour develops from cells within the brain.

However, all brain tumours are not brain cancer. But one thing to note is that even benign tumour can cause serious problems by increasing intracranial pressure or obstruct vascular structures or cerebrospinal fluid flow in the brain.

Different types of cells in the brain such as gliomas, meningiomas, pituitary adenomas, vestibular schwannomas, and primitive neuroectodermal (medulloblastomas) can become cancerous. Gliomas have several subtypes, which include astrocytomas, oligodendrogliomas, ependymomas, and choroid plexus papillomas.

Types of Brain Cancers

There are two types of brain cancer, including:

• Primary brain cancers: Primary brain cancers result when cancer cells develop in the tissues of the brain itself. Primary brain cancer cells may travel short distances within the brain but generally would not travel outside of the brain itself.
• Secondary brain cancers: Secondary brain cancer is called metastatic brain cancer. It occurs when cancer develops elsewhere in the body and spreads to the brain. Primary cancer tissues can spread via direct extension, or through the lymphatic system or through the bloodstream.

Metastatic cancer in the brain is more common than primary brain cancer. They are usually named after the tissue or organ where cancer first develops. Metastatic lung or breast cancer in the brain is the most commonly found brain cancers.

Brain Cancer Causes

The exact brain cancer cause is still unknown. However, its occurrence has been linked to several risk factors, including the following:

• Exposure to radiation
• HIV infection
• Inherited abnormality
• Smoking
• Exposure to environmental toxins
• Exposure to chemical toxins, especially those used in rubber industry and oil refinery

Brain Cancer Symptoms

Some types of brain cancers such as meningeal and pituitary gland may produce few or no symptoms. Some of the brain cancer symptoms typically experienced by patients include:

• Difficulty walking, seizures, dizziness and vertigo
• Extreme fatigue and muscle weakness
• Severe headaches and blurry vision
• Sleepiness, nausea, and vomiting
• Reduction in mental alertness, capacity or memory
• Difficulty in speaking, impaired voice or inability to speak
• Personality changes and hallucination
• Weakness on one side of the body and coordination problems
• Reduced touch sensation

A brain tumor is a cancerous or a non-cancerous growth of cells in the brain. This growth of abnormal cells can take place in any part of the brain or it can happen in any other body party and spread to the brain.

It is a fairly common condition that affects millions of people around the world. An undiagnosed brain tumour can prove fatal and therefore, it is necessary to undergo specific tests and initiate treatment as soon as the diagnosis is confirmed.

The symptoms of a brain tumour can be confused with some other medical condition, especially migraine. Increasingly strong headache and blurred vision are the two most common symptoms of a brain tumour. People with this condition can also experience seizures, confusion, nausea, vertigo, impaired voice, and loss of balance.

Treatment for a brain tumour depends on several factors. The type, size, and the location of a tumour, in addition to the overall health of the patient and his or her age, are some of the considerations made by the doctor while preparing a brain tumour treatment plan.

Different treatment modalities can be used to treat brain tumour patients and surgery, chemotherapy, and radiation therapy are among them. Usually, a combination of treatment modalities is used to conduct brain tumour treatment.

Craniotomy surgery is one of the most common types of brain surgery conducted to treat a brain tumor. It mainly aims at removing a lesion, tumor, or a blood clot in the brain by opening a flap above the brain to access the targeted area. This flap is removed on a temporary basis and again put in place when the surgery is done. Around 90 percent of the cases of brain tumors are diagnosed in adults aged between 55 and 65. Among children, a brain tumor is diagnosed within an age range of 3 to 12 years.

Craniotomy procedures are conducted with the help of magnetic resonance imaging (MRI) scans to reach the location precisely in the brain that requires treatment. A three-dimensional image for the same is achieved of the brain in conjunction with localizing frames and computers to view a tumor properly. A clear distinction is made between abnormal or tumor tissue and normal healthy tissue and to access the exact location of the abnormal tissue.

Who requires a craniotomy?

In a minimally invasive craniotomy procedure, a burr hole or a keyhole may be created to access the brain to fulfill the following purposes:

• To drain out cerebrospinal fluid in case of hydrocephalus by inserting a shunt into the ventricles
• To treat Parkinson’s disease by inserting a deep brain stimulator (DBS)
• To insert an intracranial pressure monitor
• To conduct needle biopsy, where a small sample of abnormal tissue is removed for study
• For stereotactic hematoma aspiration, in which a blood clot is drained out
• For insertion of an endoscope to clip aneurysms and for the removal of small tumors

When there are complex craniotomies involved, the procedure may be referred to as a skull base surgery.  In this kind of surgery, a small portion of the skull is removed from the bottom of the brain. This is the region where delicate arteries, veins, and cranial nerves exit the skull. Complicated planning is done to plan such craniotomies and understand the location of the lesions. This type of approach is usually employed for:

• The removal or treatment of large brain tumors and aneurysm in the brain
• Treatment after a skull fracture or major injury like a gunshot
• The removal of a malignant tumor affecting the bony skull

Primary brain tumors are much less common than secondary brain tumors. Primary ones are found to originate very close to the brain itself or in the tissues very close to it, such as the covering membranes of the brain, including the meninges, cranial nerves, pineal, or pituitary gland. It begins with normal cells, which at a later period undergoes some mutational errors in their DNA. The mutation triggers cells to grow and divide at a very high rate while healthy cells keep dying around it. This results in a mass of abnormal cells which gives rise to a tumor. Unlike primary tumors, the secondary tumors begin as cancer elsewhere and spread to the brain.

Symptoms of brain tumor

• Different patterns of a headache
• Headaches get more frequent and acutely painful
• Nausea
• Blurred vision, double vision, or loss of peripheral vision
• Loss of sensation in the arm or any leg gradually
• Balance difficulty
• Speech problems with confusion in simple matters
• Hearing problems
• Personality change
• Sudden seizures and attacks or bouts of pain
  
  

Types of Craniotomy

No matter what the goal of the surgery is, it is best to ensure that the incision is made to address the intracranial lesion keeping some principles in mind. A wide variety of intracranial processes can be done via a craniotomy with a different variety of incisions. Some of these variations include frontal craniotomy, pterional craniotomy, temporal craniotomy, decompression craniectomy, and suboccipital craniotomy.

• Ventriculoperitoneal shunt is commonly known as VP shunt. It is a medical device that relieves pressure on the brain caused by excess cerebro-spinal fluid (CSF) accumulation. VP shunt is designed to primarily treat a medical condition called hydrocephalus, which occurs when excess CSF collects in the ventricles of the brain.
• The role of fluid on the brain is to protect it from injury inside the skull. CSF acts as a delivery system for nutrients that the brain needs and takes away waste products. Fluid on the brain is reabsorbed into the blood.
• Hydrocephalus occurs when the normal flow of CSF is disrupted or the reabsorbtion of CSF in the blood is reduced. This condition can, thus, create an adverse pressure on the tissues of the brain and harm it. A brain shunt surgery can help rectify this condition by diverting the CSF away from the brain, which restores normal flow and absorption of CSF. VP shunt is surgically placed inside one of the ventricles of the brain.