Neuro Swasthya

Hi,

I am Dr. Arun Sharma, Neurosurgeon, Indian Spinal Injuries Centre, Delhi. Today I will talk about a brain tumor. A brain tumor is a cancerous or non-cancerous mask or growth of abnormal cells. Iska matlab hai ki jo har rasoli hai vo cancerous nahi hoti hai. Islia cancer ka naam brain tumor se nahi jodna chaiye. Brain tumor ke karan kya ho sakte hain? The exact cause for a brain tumor is not known. But radiation has been implicated in many of the brain tumors. What are the symptoms of a brain tumor? Brain tumor se humein sir dard ho sakta hai, vomiting ho sakti hai, chalne mein dikkat ho sakti hai, haath pair mein kamjoori aa sakti hai, sunne mein dikkat, dikhayi dene mein dikkat, double dikhna, behavior changes aa sakte hain, aur kisi kis mein yadash mein changes aa sakte hain. Now, we come to the diagnosis. We can get the CT scan done. MRI scan can be done. MRI angiography helps us to localize the tumor, size of the tumor, the location. We can see where the tumor is coming. It also can be done brain abscess. Then we can do the biopsy for the deep sitted tumor. This helps us to know the tumor by getting the biopsy done. This will be done with a very small hole. A brain tumor is of 3 types. One is a benign tumor, 2nd is a malignant tumor and 3rd is a metastatic tumor. All are a non-cancerous tumor and they can be removed completely. Then only we can think that it is cured after removing completely.

Malignant tumors are high-grade tumors which have high growth and grow very fast. The metastatic tumor is the tumor which comes to the brain from various other parts of the body. This malignant tumors and benign tumors can be classified into 4 grades. Grade 1 and 2 which is usually considered as low grade and 3 & 4 are malignant one which is known as a high-grade tumor. The grade of the tumor can be known somewhat on radiology and biopsy of the tumor. In adults, the most common tumors are astrocytoma, meningioma tumor and in children is a metastasis. Now we come to the treatment of the tumor. One is surgical treatment. The surgical depends on the location of the tumor, size of the tumor, the involvement of the tumor. Some benign tumor can be excised completely which completely needs a cure of the brain tumor. Some may require or may not require radiotherapy and chemotherapy for the treatment. And in some cases in which there have been neurological deficits caught by the brain tumor then these patients require further rehabilitation.

What are the latest techniques which I have been evolved over a period of years to help in the management of the tumor? One of the most important things is neuronavigation in which we can localize the brain tumors so that this helps in minimizing the size of the tumor and complete excision of the tumor. 2nd is biopsy in which with a small hole in the scalp, we can reach the deep sitted tumors, obtain a biopsy with minimal and no neurological deficit. We can know the type of treatment. We can help the patient by providing radiotherapy and chemotherapy. 3rd is gamma knife and cyberknife which provides a high bim of focused x-rays to the tumourous portion. This helps in minimizing the damage. Gamma knife is helpful for very small tumors in critical locations which may be difficult to excise.

Thank You.

Hello,

I am Dr. Arun Sharma consultant Neurosurgeon. I received my neurosurgical training from the nationally reputed GB pant hospital affiliated with Maulana Azad Medical College and Delhi University. I have received further training in neurosurgery from John Hopkins, Baltimore and Pittsburgh USA. Today we are going to talk about the spinal tumors which are a very important part of the disease in many patients. The spinal tumor means Jo spine ke ander tumor hai our spine is made up of 33 column of bones, these bones form a circle and inside this circle lies a spinal cord which causes the transmission of messages from our brain to various parts of our body and messages from various parts of our body to the brain.

Spinal tumor, any tumor, what is a tumor? tumor is an abnormal growth of cell mass, which can cause compression and create a problem for the patient, here we see that spinal tumor can lie anywhere across the spine, it can lie outside the spinal cord, it can lie inside the spinal cord and it can within the spinal cord. The tumors which lie outside the spinal cord are extradural and they arise from this bone mass, from the nerve root, from the dura mater and they can be ewing's sarcoma, sometimes neurofibromas also lie outside the spinal cord, then come the intradural extramedullary, which are inside the spinal cord but outside the spinal cord substance they are inside the dura mater. They cause compression of the spinal cord and cause the patient symptoms, these may include neurofibroma, schwannoma and meningiomas which are the most common.

Then we have intramedullary tumors which are mostly gliomas or ependymomas, which developed in the substance of the spinal cord and these are one of the most devastating tumors, the majority of spinal tumors are benign matlab ki cancerous nahin hai. What are the presentations caused by the tumor which bring a patient to the doctor? it can be local pain, local pain kamar mein kahin bhi kisi bhi hisse mein dard ho sakta hai. Dusra radicular pain ek pair mein dard jo raha hai jaise disk khisakne ka dard hota hai vaisa dard ho sakta hai, hath pair mein kamjori aa sakti hai, bladder-bowel control kho sakta hai, sensation ja sakti hai, chalne mein dikkat ho sakti hai, likhane mein dikkat ho sakti hain, kisi bhi saman ko pakdane mein dikkat ho sakti hai ye sab anya samasyaen spinal cord tumor ki vajah se ho sakti hai. Kahi bahar spine mein tedapan bhi tumor ki vajah se ho sakta hai jisko scoliosis khate hain. Diagnostic workup, it includes a detailed neurological examination of the patient which will point to the deficits in the patient and will help us in asking for investigations of that respective part which can be cervical, dorsal or lumbar sacral. We should get an MRI of the spine of that related part with contrast CT of the spine may or may not be required as per the symptoms of the patient. uroflowmetry and urodynamics studies may be required on a case-to-case basis.

Now management, management includes excision of the spinal tumor without causing further neurological deficit, this helps in improving the quality of life, this reverses the patient's symptoms, the patient's deficit don't increase, they improve with rehabilitation, so surgical excision of the spinal tumors which are causing symptoms in the patient is the management of the spinal tumor. These tumors if excised surgically and on time, they can help in leading a better quality of life in these patients. So my advice is whenever you have a spinal tumor which is causing symptoms, you should consult a doctor, don't ignore the symptoms, you should properly get it investigated and if excised on time it will help you. I thank you all for listening to this talk on spinal tumors.

Thank you