Brain tumor Classification and external resources
CT scan of brain showing brain cancer metastatic to the left parietal lobe in the peri-ventricular area. Computed tomography (CT is a Medical imaging method employing Tomography. The parietal lobe is a lobe in the Brain. It is positioned above (superior to the Occipital lobe and behind (posterior to the Frontal lobe. The ventricular system is a set of structures in the Brain continuous with the Central canal of the Spinal cord.
ICD-10	C71., D33.0-D33.2
ICD-9	191, 225.0
DiseasesDB	30781
MedlinePlus	007222 000768
eMedicine	emerg/334
MeSH	D001932

A brain tumor is any intracranial tumor created by abnormal and uncontrolled cell division, normally either in the brain itself (neurons, glial cells (astrocytes, oligodendrocytes, ependymal cells), lymphatic tissue, blood vessels), in the cranial nerves (myelin-producing Schwann cells), in the brain envelopes (meninges), skull, pituitary and pineal gland, or spread from cancers primarily located in other organs (metastatic tumors). The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify Diseases The International Statistical Classification of Diseases and Related Health Problems 10th Revision ( ICD -10) is a coding of diseases and signs symptoms abnormal findings The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify Diseases The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. The Diseases Database is a free Website that provides information about the relationships between medical conditions Symptoms, and Medications. MedlinePlus, with the MedlinePlus Medical Encyclopedia, is a website network containing Health information from the world's largest medical Library eMedicine is an online clinical medical knowledge base that was founded in 1996 by Scott Plantz and Richard Lavely two medical doctors Medical Subject Headings ( MeSH) is a huge Controlled vocabulary (or metadata system for the purpose of indexing journal articles and books See also Cancer A tumor or tumour is the name for a swelling or lesion formed by an abnormal growth of cells (termed neoplastic Mitosis is the process in which a Eukaryotic cell separates the Chromosomes in its Cell nucleus, into two identical sets in two daughter nuclei The brain is the center of the Nervous system in animals All Vertebrates and the majority of Invertebrates have a brain Neurons (ˈnjuːɹɒn also known as neurones and nerve cells) are responsive cells in the Nervous system that process and transmit information Glial cells, commonly called neuroglia or simply glia (Greek for "glue" are non- Neuronal cells that provide support and nutrition Astrocytes (also known collectively as astroglia) are characteristic star-shaped glial cells in the Brain and Spinal cord. Origin Oligodendroglia arise during development from an Oligodendrocyte precursor cell, which can be identified by its expression of a number of Antigens, including Ependyma is the thin epithelial membrane lining the Ventricular system of the Brain and the Spinal cord. The lymphatic system in Vertebrates is a network of conduits that carry a clear fluid called Lymph. The blood vessels are part of the Circulatory system and function to transport Blood throughout the body Cranial nerves are Nerves that emerge directly from the Brain stem in contrast to Spinal nerves which emerge from segments of the Spinal cord. Myelin is an electrically-insulating Dielectric Phospholipid layer that surrounds only the Axons of many Neurons It is an outgrowth Named after the German physiologist Theodor Schwann, Schwann cells (also referred to as neurolemmocytes) are a variety of Glial cell that mainly The meninges (singular meninx) is the system of membranes which envelops the Central nervous system. The pituitary gland, or hypophysis, is an Endocrine gland about the size of a Pea. The pineal gland (also called the pineal body, epiphysis cerebri, or epiphysis) is a small endocrine gland in the vertebrate Brain Cancer (medical term Malignant Neoplasm) is a class of Diseases in which a group of cells display uncontrolled Metastasis ( Greek: displacement μετά=next + στάσις=placement, plural metastases) sometimes abbreviated mets, Primary (true) brain tumors are commonly located in the posterior cranial fossa in children and in the anterior two-thirds of the cerebral hemispheres in adults, although they can affect any part of the brain. The posterior cranial fossa is part of the Intracranial cavity, located between the Foramen magnum and Tentorium cerebelli. CHILD syndrome (or congenital hemidysplasia with ichthyosiform erythroderma and limb defects) is a genetic disorder A cerebral hemisphere ( hemispherium cerebrale) is defined as one of the two regions of the Brain that are delineated by the body's median plane. For the 2008 British film by Noel Clarke see Adulthood (film. The brain is the center of the Nervous system in animals All Vertebrates and the majority of Invertebrates have a brain In the United States in the year 2005, it was estimated that there were 43,800 new cases of brain tumors (Central Brain Tumor Registry of the United States, Primary Brain Tumors in the United States, Statistical Report, 2005 - 2006),^[1] which accounted for 1. The United States of America —commonly referred to as the 4 percent of all cancers, 2. 4 percent of all cancer deaths,^[2] and 20–25 percent of pediatric cancers. ^[2][3] Ultimately, it is estimated that there are 13,000 deaths/year as a result of brain tumors. ^[1]

Classification

Primary tumors

Tumors occurring in the brain include: astrocytoma, pilocytic astrocytoma, dysembryoplastic neuroepithelial tumor, oligodendrogliomas, ependymoma, glioblastoma multiforme, mixed gliomas, oligoastrocytomas, medulloblastoma, retinoblastoma, neuroblastoma, germinoma and teratoma. Astrocytomas are primary Central nervous system Tumors that arise primarily in and rarely spread away from the CNS parenchyma contained within the Cranial vault Pilocytic astrocytoma, or juvenile pilocytic astrocytoma, is a brain tumor that occurs predominantly in children and involves the midline basal and posterior Fossa Dysembryoplastic neuroepithelial tumour, commonly abbreviated DNT or DNET, is a type of Brain tumour that arises from the Oligodendrocyte, a Oligodendrogliomas are a type of Glioma that are believed to originate from the Oligodendrocytes of the Brain or from a glial precursor cell Ependymoma is a Tumor that arises from the Ependyma, a tissue of the Central nervous system. Glioblastoma multiforme ( GBM) is the most common and most aggressive type of primary Brain Tumor, accounting for 52% of all primary brain tumor Oligoastrocytomas are a subset of Brain tumor that present with an appearance of mixed glial cell origin Astrocytoma and Oligodendroglioma. Oligoastrocytomas are a subset of Brain tumor that present with an appearance of mixed glial cell origin Astrocytoma and Oligodendroglioma. Medulloblastoma is a highly Malignant primary Brain tumor that originates in the Cerebellum or posterior fossa. Retinoblastoma is a Cancer of the Retina. Development of this tumor is initiated by Mutations ref> that inactivate both copies of the RB1 Neuroblastoma is the most common extracranial solid Cancer in childhood and the most common cancer in infancy with an annual incidence of about 650 new cases per year in the A germinoma is a type of Germ cell tumor which is not differentiated upon examination A teratoma is a type of neoplasm. The word teratoma comes from Greek and means roughly "monstrous tumor"

MRI image showing a low-grade brain glioma in a 28 year-old male. Image created on 2007-07-10. Year 2007 ( MMVII) was a Common year starting on Monday of the Gregorian calendar in the 21st century. Events 48 BC - Battle of Dyrrhachium, Julius Caesar barely avoids a catastrophic defeat to Pompey in Macedonia.

Most primary brain tumors originate from glia (gliomas) such as astrocytes (astrocytomas), oligodendrocytes (oligodendrogliomas), or ependymal cells (ependymoma). Glial cells, commonly called neuroglia or simply glia (Greek for "glue" are non- Neuronal cells that provide support and nutrition A glioma is a type of Cancer that starts in the brain or spine Astrocytomas are primary Central nervous system Tumors that arise primarily in and rarely spread away from the CNS parenchyma contained within the Cranial vault Oligodendrogliomas are a type of Glioma that are believed to originate from the Oligodendrocytes of the Brain or from a glial precursor cell Ependymoma is a Tumor that arises from the Ependyma, a tissue of the Central nervous system. There are also mixed forms, with both an astrocytic and an oligodendroglial cell component. These are called mixed gliomas or oligoastrocytomas. Oligoastrocytomas are a subset of Brain tumor that present with an appearance of mixed glial cell origin Astrocytoma and Oligodendroglioma. Oligoastrocytomas are a subset of Brain tumor that present with an appearance of mixed glial cell origin Astrocytoma and Oligodendroglioma. Plus, mixed glio-neuronal tumors (tumors displaying a neuronal, as well as a glial component, e. g. gangliogliomas, disembryoplastic neuroepithelial tumors) and tumors originating from neuronal cells (e. Ganglioglioma or gangliocytoma refers a tumour that arises from Ganglion cells in the Central nervous system. Dysembryoplastic neuroepithelial tumour, commonly abbreviated DNT or DNET, is a type of Brain tumour that arises from the Oligodendrocyte, a g. gangliocytoma, central gangliocytoma) can also be encountered.

Other varieties of primary brain tumors include: primitive neuroectodermal tumors (PNET, e. Primitive neuroectodermal tumor (PNET is a rare Tumor, usually occurring in children under 10 years old g. medulloblastoma, medulloepithelioma, neuroblastoma, retinoblastoma, ependymoblastoma), tumors of the pineal parenchyma (e. Medulloblastoma is a highly Malignant primary Brain tumor that originates in the Cerebellum or posterior fossa. Neuroblastoma is the most common extracranial solid Cancer in childhood and the most common cancer in infancy with an annual incidence of about 650 new cases per year in the Retinoblastoma is a Cancer of the Retina. Development of this tumor is initiated by Mutations ref> that inactivate both copies of the RB1 Primitive neuroectodermal tumor (PNET is a rare Tumor, usually occurring in children under 10 years old The pineal gland (also called the pineal body, epiphysis cerebri, or epiphysis) is a small endocrine gland in the vertebrate Brain Parenchyma is a term used to describe a bulk of a substance It is used in different ways in Animals and in Plants. g. pineocytoma, pineoblastoma), ependymal cell tumors, choroid plexus tumors, neuroepithelial tumors of uncertain origin (e. Ependyma is the thin epithelial membrane lining the Ventricular system of the Brain and the Spinal cord. The choroid plexus is the area on the ventricles of the brain where Cerebrospinal fluid (CSF is produced by modified Ependymal cells. g. gliomatosis cerebri, astroblastoma), etc. Gliomatosis cerebri (infiltrative diffuse astrocytosis is a rare primary Brain tumor.

From a histological perspective, astrocytomas, oligondedrogliomas, oligoastrocytomas, and teratomas may be benign or malignant. A benign tumor is a Tumor that lacks all three of the Malignant properties of a Cancer. Cancer (medical term Malignant Neoplasm) is a class of Diseases in which a group of cells display uncontrolled Glioblastoma multiforme represents the most aggressive variety of malignant glioma. Glioblastoma multiforme ( GBM) is the most common and most aggressive type of primary Brain Tumor, accounting for 52% of all primary brain tumor At the opposite end of the spectrum, there are so-called pilocytic astrocytomas, a distinct variety of astrocytic tumors. Pilocytic astrocytoma, or juvenile pilocytic astrocytoma, is a brain tumor that occurs predominantly in children and involves the midline basal and posterior Fossa The majority of them are located in the posterior cranial fossa, affect mainly children and young adults, and have a clinically favorable course and prognosis. The posterior cranial fossa is part of the Intracranial cavity, located between the Foramen magnum and Tentorium cerebelli. Teratomas and other germ cell tumors also may have a favorable prognosis, although they have the capacity to grow very large. A teratoma is a type of neoplasm. The word teratoma comes from Greek and means roughly "monstrous tumor" A germ cell tumor ( GCT) is a Neoplasm derived from Germ cells Germ cells normally occur inside the gonads ( Ovary and Testis)

Another type of primary intracranial tumor is primary cerebral lymphoma, also known as primary CNS lymphoma, which is a type of non-Hodgkin's lymphoma that is much more prevalent in those with severe immunosuppression, e. Primary CNS lymphoma is a primary intracranial tumor usually present in those with severe immunosuppression --- commonly in those with AIDS --- and represents Primary CNS lymphoma is a primary intracranial tumor usually present in those with severe immunosuppression --- commonly in those with AIDS --- and represents g. AIDS.

In contrast to other types of cancer, primary brain tumors rarely metastasize, and in this rare event, the tumor cells spread within the skull and spinal canal through the cerebrospinal fluid, rather than via bloodstream to other organs. Cancer (medical term Malignant Neoplasm) is a class of Diseases in which a group of cells display uncontrolled The spinal canal (or vertebral canal or spinal cavity) is the space in Vertebrae through which the Spinal cord passes Cerebrospinal fluid ( CSF) Liquor cerebrospinalis, is a clear Bodily fluid that occupies the Subarachnoid space and the Ventricular system

There are various classification systems currently in use for primary brain tumors, the most common being the World Health Organization (WHO) brain tumor classification, introduced in 1993. Year 1993 ( MCMXCIII) was a Common year starting on Friday (link will display full 1993 Gregorian calendar)

Secondary tumors and non-tumor lesions

Secondary or metastatic brain tumors originate from malignant tumors (cancers) located primarily in other organs. Metastasis ( Greek: displacement μετά=next + στάσις=placement, plural metastases) sometimes abbreviated mets, Cancer (medical term Malignant Neoplasm) is a class of Diseases in which a group of cells display uncontrolled Their incidence is higher than that of primary brain tumors. The most frequent types of metastatic brain tumors originate in the lung, skin (malignant melanoma), kidney (hypernephroma), breast (breast carcinoma), and colon (colon carcinoma). lung is the essential Respiration organ in air-breathing Animals including most Tetrapods a few Fish and a few Snails The most primitive The skin is the outer covering of living tissue of an animal (or plant Melanoma is a Malignant Tumor of Melanocytes which are found predominantly in skin but also in the Bowel and the Eye (see The kidneys are complicated organs that have numerous biological roles "Kidney Cancer" redirects here For Wilms' Tumor/Nephroblastoma see Wilms' tumor. The breast is the upper Ventral region of an animal’s Torso, particularly that of Mammals including Human beings. Breast cancer is a Cancer that starts in the cells of the Breast in women and men The colon is a storage tube for solid wastes The main function of the colon appears to be extraction of Water and salts from Feces. Colorectal cancer, also called colon cancer or large bowel cancer, includes Cancerous growths in the colon, Rectum and These tumor cells reach the brain via the blood-stream.

Some non-tumoral masses and lesions can mimic tumors of the central nervous system. In Vertebrates the central nervous system ( CNS) is the part of the Nervous system which is enclosed in the Meninges. These include tuberculosis of the brain, cerebral abscess (commonly in toxoplasmosis), and hamartomas (for example, in tuberous sclerosis and von Recklinghausen neurofibromatosis). Tuberculosis (abbreviated as TB for tubercle bacillus or T u' b' erculosis Bacillus --> is a common Brain abscess (or cerebral abscess is an Abscess caused by inflammation and collection of infected material coming from local (ear infection Dental abscess, infection Toxoplasmosis is a Parasitic disease caused by the Protozoan Toxoplasma gondii. A hamartoma is a benign focal malformation that resembles a neoplasm in the tissue of its origin Tuberous sclerosis or tuberous sclerosis complex ( TSC) is a rare multi-system genetic disease that causes benign tumours to grow in the Brain Neurofibromatosis type I ( NF-1) also known as '''von Recklinghausen''' disease, is a rare inherited disease

WHO Classification of Tumors of the Central Nervous System

The website http://www.brainlife.org describes the various WHO (World Health Organization) classifications of brain tumors, from 1979 to 2007. The most recent WHO classification of brain tumors is on page http://www.brainlife.org/who/2007_classification.htm.

Brain tumors in infants and children

In 2000 approximately 2. 76 children per 100,000 were affected by a CNS tumor in the United States. This rate has been increasing and by 2005 was 3. 0 children per 100,000. This is approximately 2,500-3,000 pediatric brain tumors occurring each year in the US. The tumor incidence is increasing by about 2. 7% per year. The CNS Cancer survival rate in children is approximately 60%. In Vertebrates the central nervous system ( CNS) is the part of the Nervous system which is enclosed in the Meninges. ^[4] However, this rate varies with the age of onset (younger has higher mortality) and cancer type.

In children under 2, about 70% of brain tumors are medulloblastoma, ependymoma, and low-grade glioma. Medulloblastoma is a highly Malignant primary Brain tumor that originates in the Cerebellum or posterior fossa. Ependymoma is a Tumor that arises from the Ependyma, a tissue of the Central nervous system. A glioma is a type of Cancer that starts in the brain or spine Less commonly, and seen usually in infants, are teratoma and atypical teratoid rhabdoid tumor. A teratoma is a type of neoplasm. The word teratoma comes from Greek and means roughly "monstrous tumor" Atypical teratoid rhabdoid tumor ( AT/RT) is a rare Tumor usually diagnosed in childhood ^[5]

Signs and symptoms

Symptoms of brain tumors may depend on two factors: tumor size (volume) and tumor location. The time point of symptom onset in the course of disease correlates in many cases with the nature of the tumor ("benign", i. e. slow-growing/late symptom onset, or malignant, fast growing/early symptom onset).

Many low-grade (benign) tumors can remain asymptomatic (symptom-free) for years and they may accidentally be discovered by imaging exams for unrelated reasons (such as a minor trauma).

New onset of epilepsy^[6] is a frequent reason for seeking medical attention in brain tumor cases. An epileptic seizure is caused by excessive and/or hypersynchronous electrical Neuronal activity and is usually self-limiting

Large tumors or tumors with extensive perifocal swelling edema inevitably lead to elevated intracranial pressure (intracranial hypertension), which translates clinically into headaches, vomiting (sometimes without nausea), altered state of consciousness (somnolence, coma), dilatation of the pupil on the side of the lesion (anisocoria), papilledema (prominent optic disc at the funduscopic examination). Oedema (or Edema in American English formerly known as dropsy or hydropsy, is the increase of Interstitial fluid in any organ &mdash swelling Intracranial pressure, ( ICP) is the pressure exerted by the Cranium on the Brain tissue Cerebrospinal fluid (CSF and the brain's circulating A headache ( cephalalgia in medical terminology is a condition of pain in the Head; sometimes Neck or upper back pain may also be interpreted Vomiting (also called throwing up, emesis) is the forceful expulsion of the contents of one's Stomach through the Mouth and sometimes the Nausea ( Latin: Nausea, Greek:, " Sea-sickness " also called wamble) is the sensation of unease and discomfort Consciousness has been defined loosely as a constellation of attributes of Mind such as Subjectivity, Self-awareness, Sentience, and the Somnolence (or " drowsiness " is a state of near- Sleep, a strong desire for sleep or sleeping for unusually long periods (c In Medicine, a coma (from the Greek koma, meaning deep sleep is a profound state of Unconsciousness. Anisocoria is a condition characterized by an unequal size of the Pupils Causes In the absence of any deformities of the iris or eyeball proper anisocoria is Papilledema (or papilloedema) is Optic disc swelling that is caused by increased Intracranial pressure. The optic disc or optic nerve head is the location where Ganglion cell axons exit the Eye to form the Optic nerve. However, even small tumors obstructing the passage of cerebrospinal fluid (CSF) may cause early signs of increased intracranial pressure. Cerebrospinal fluid ( CSF) Liquor cerebrospinalis, is a clear Bodily fluid that occupies the Subarachnoid space and the Ventricular system Intracranial pressure, ( ICP) is the pressure exerted by the Cranium on the Brain tissue Cerebrospinal fluid (CSF and the brain's circulating Increased intracranial pressure may result in herniation (i. Intracranial pressure, ( ICP) is the pressure exerted by the Cranium on the Brain tissue Cerebrospinal fluid (CSF and the brain's circulating A hernia is a protrusion of a tissue, structure or part of an organ through the muscular tissue or the membrane by which it is normally contained e. displacement) of certain parts of the brain, such as the cerebellar tonsils or the temporal uncus, resulting in lethal brainstem compression. The cerebellar tonsil ( amygdaline nucleus) is a rounded mass situated in the hemispheres of the Cerebellum. The anterior extremity of the Hippocampal gyrus is recurved in the form of a hook the uncus, which is separated from the apex of the Temporal lobe by a slight fissure The brain stem (or brainstem) is the lower part of the Brain, adjoining and structurally continuous with the Spinal cord. In young children, elevated intracranial pressure may cause an increase in the diameter of the skull and bulging of the fontanelles. Intracranial pressure, ( ICP) is the pressure exerted by the Cranium on the Brain tissue Cerebrospinal fluid (CSF and the brain's circulating References in Pop Culture The dragon in John Gardner's 1971 novel Grendel makes reference to the fontanele as a mark of the universe's progress

Depending on the tumor location and the damage it may have caused to surrounding brain structures, either through compression or infiltration, any type of focal neurologic symptoms may occur, such as cognitive and behavioral impairment, personality changes, hemiparesis, (hemi) hypesthesia, aphasia, ataxia, visual field impairment, facial paralysis, double vision, tremor etc. The brain is the center of the Nervous system in animals All Vertebrates and the majority of Invertebrates have a brain A focal neurologic symptom is a problem that occurs in the Brain or Nervous system. Cognition is a concept used in different ways by different disciplines but is generally accepted to mean the process of awareness or thought Behavior or behaviour (see spelling differences) refers to the actions or Reactions of an object or Organism, usually Hemiparesis is the partial Paralysis of one side of the body It is generally caused by lesions of the Corticospinal tract, which runs down from the cortical Ataxia (from Greek α- as a negative prefix + -τάξις, meaning "lack of order" is a neurological sign and symptom consisting The term visual field is sometimes used as a Synonym to Field of view, though they do not designate the same thing Facial nerve paralysis is a common problem that involves the Paralysis of any structures innervated by the Facial nerve. Tremor is an unintentional somewhat rhythmic muscle movement involving to-and-from movements (oscillations of one or more parts of the body These symptoms are not specific for brain tumors - they may be caused by a large variety of neurologic conditions (e. g. stroke, traumatic brain injury). A stroke is the rapidly developing loss of brain functions due to a disturbance in the blood vessels supplying blood to the brain Traumatic brain injury (TBI also called intracranial injury, occurs when Physical trauma injures the Brain. What counts, however, is the location of the lesion and the functional systems (e. g. motor, sensory, visual, etc. ) it affects.

A bilateral temporal visual field defect (bitemporal hemianopia—due to compression of the optic chiasm), often associated with endocrine disfunction—either hypopituitarism or hyperproduction of pituitary hormones and hyperprolactinemia is suggestive of a pituitary tumor. The term visual field is sometimes used as a Synonym to Field of view, though they do not designate the same thing Bitemporal hemianopsia (or Bitemporal hemianopia) is the medical description of a type of partial Blindness where vision is missing in the outer half of both the right The optic chiasm ( Greek χίασμα "crossing" from the Greek χλαζειν 'to mark with an X' after the Greek letter ' Χ ' chi) is the Hypopituitarism is the decreased ( hypo) secretion of one or more of the eight Hormones normally produced by the Pituitary gland at the base of the Brain Hormones (from Greek ὁρμή - "impetus" are chemicals released by cells that affect cells in other parts of the body Hyperprolactinaemia ( BrE) or hyperprolactinemia ( AmE) is the presence of abnormally-high levels of Prolactin in the blood

Diagnosis

Although there is no specific clinical symptom or sign for brain tumors, slowly progressive focal neurologic signs and signs of elevated intracranial pressure, as well as epilepsy in a patient with a negative history for epilepsy should raise red flags. Focal neurologic signs also known as focal signs or focal CNS signs are perceptual or behavioral impairments which are caused by lesions in a particular area of the central nervous system However, a sudden onset of symptoms, such as an epileptic seizure in a patient with no prior history of epilepsy, sudden intracranial hypertension (this may be due to bleeding within the tumour, brain swelling or obstruction of cerebrospinal fluid's passage) is also possible. Epilepsy is a common chronic Neurological disorder that is characterized by recurrent unprovoked seizures. Cerebrospinal fluid ( CSF) Liquor cerebrospinalis, is a clear Bodily fluid that occupies the Subarachnoid space and the Ventricular system

Glioblastoma multiforme and anaplastic astrocytoma have been associated in case reports on Pubmed with the genetic acute hepatic porphyrias, including positive testing associated with drug refractory seizures. Unexplained complications associated with drug treatments with these tumors should alert physicians to an undiagnosed neurological porphyria.

Symptoms include phantom odors and tastes. Taste (or more formally gustation) is a form of direct Chemoreception and is one of the traditional five Senses Often, in the case of metastatic tumors, the smell of vulcanized rubber is prevalent. Vulcanization (or Vulcanisation refers to a specific curing process of Rubber involving high heat and the addition of Sulfur or other equivalent curatives

Imaging plays a central role in the diagnosis of brain tumors. Early imaging methods—invasive and sometimes dangerous—such as pneumoencephalography and cerebral angiography, have been abandoned in recent times in favor of non-invasive, high-resolution modalities, such as computed tomography (CT) and especially magnetic resonance imaging (MRI). Pneumoencephalography (sometimes abbreviated PEG is a Medical procedure in which Cerebrospinal fluid is drained to a small amount from around the Brain Angiography or arteriography is a Medical imaging technique in which an X-ray image is taken to visualize the inside or lumen, of blood vessels Computed tomography (CT is a Medical imaging method employing Tomography. Benign brain tumors often show up as hypodense (darker than brain tissue) mass lesions on cranial CT-scans. On MRI, they appear either hypo- (darker than brain tissue) or isointense (same intensity as brain tissue) on T1-weighted scans, or hyperintense (brighter than brain tissue) on T2-weighted MRI. Perifocal edema also appears hyperintense on T2-weighted MRI. Contrast agent uptake, sometimes in characteristic patterns, can be demonstrated on either CT or MRI-scans in most malignant primary and metastatic brain tumors. Contrast medium Radiocontrast agents (also simply contrast agents or contrast materials) are compounds used to improve the visibility of internal bodily structures This is due to the fact that these tumors disrupt the normal functioning of the blood-brain barrier and lead to an increase in its permeability. The blood-brain barrier (BBB is a metabolic or cellular structure in the Central nervous system (CNS that restricts the passage of various chemical substances and microscopic

Electrophysiological exams, such as electroencephalography (EEG) play a marginal role in the diagnosis of brain tumors.

The definitive diagnosis of brain tumor can only be confirmed by histological examination of tumor tissue samples obtained either by means of brain biopsy or open surgery. Diagnosis is the identification by Process of elimination, of the nature of anything Histology (from the Greek = 'tissue' is the study of the microscopic anatomy of cells and tissues of Plants and See also Cancer A tumor or tumour is the name for a swelling or lesion formed by an abnormal growth of cells (termed neoplastic Tissue is a cellular organizational level intermediate between cells and a complete organism A biopsy (in Greek: βίος life and όψη look/appearance is a Medical test involving the removal of cells or tissues Surgery (from the χειρουργική cheirourgikē, via chirurgiae meaning "hand work" is a medical specialty that uses operative manual and instrumental The histologic examination is essential for determining the appropriate treatment and the correct prognosis. Prognosis (older Greek πρόγνωσις modern Greek πρόγνωση - literally fore-knowing foreseeing) is a medical term denoting the This examination, performed by a pathologist, typically has three stages: interoperative examination of fresh tissue, preliminary microscopic examination of prepared tissues, and followup examination of prepared tissues after immunohistochemical staining or genetic analysis. Pathology (from Greek grc πάθος pathos, "fate harm" and grc -λογία -logia) is the study and

Treatment and prognosis

Many meningiomas, with the exception of some tumors located at the skull base, can be successfully removed surgically. Meningiomas are the most common Benign Tumors of the Brain (95% of benign tumors In more difficult cases, stereotactic radiosurgery, such as Gamma Knife radiosurgery, remains a viable option. Stereotactic surgery or stereotaxy is a Minimally-invasive form of surgical intervention which makes use of a three-dimensional Coordinates system Radiosurgery, also known as stereotactic radiotherapy is a Medical procedure which allows non-invasive treatment of benign and malignant conditions avascular malformations Gamma Knife® (or Leksell Gamma Knife®) is a device used to treat Brain tumors with a high dose of Radiation therapy in one day Radiosurgery, also known as stereotactic radiotherapy is a Medical procedure which allows non-invasive treatment of benign and malignant conditions avascular malformations

Most pituitary adenomas can be removed surgically, often using a minimally invasive approach through the nasal cavity and skull base (trans-nasal, trans-sphenoidal approach). Pituitary adenomas are Tumors that occur in the Pituitary gland, and account for about 10% of intracranial neoplasms. The nasal cavity (or nasal fossa) is a large air-filled space above and behind the nose in the middle of the face Large pituitary adenomas require a craniotomy (opening of the skull) for their removal. Pituitary adenomas are Tumors that occur in the Pituitary gland, and account for about 10% of intracranial neoplasms. A craniotomy is a surgical operation in which part of the Skull, called a bone flap, is removed in order to access the brain Radiotherapy, including stereotactic approaches, is reserved for the inoperable cases. Stereotactic surgery or stereotaxy is a Minimally-invasive form of surgical intervention which makes use of a three-dimensional Coordinates system

Although there is no generally accepted therapeutic management for primary brain tumors, a surgical attempt at tumor removal or at least cytoreduction (that is, removal of as much tumor as possible, in order to reduce the number of tumor cells available for proliferation) is considered in most cases. ^[7] However, due to the infiltrative nature of these lesions, tumor recurrence, even following an apparently complete surgical removal, is not uncommon. Postoperative radiotherapy and chemotherapy are integral parts of the therapeutic standard for malignant tumors. Radiotherapy may also be administered in cases of "low-grade" gliomas, when a significant tumor burden reduction could not be achieved surgically.

Survival rates in primary brain tumors depend on the type of tumor, age, functional status of the patient, the extent of surgical tumor removal, to mention just a few factors. ^[8]

UCLA Neuro-Oncology publishes real-time survival data for patients with this diagnosis. They are the only institution in the United States that shows how brain tumor patients are performing on current therapies. The United States of America —commonly referred to as the They also show a listing of chemotherapy agents used to treat High Grade Giloma tumors.

Patients with benign gliomas may survive for many years,^[9][10] while survival in most cases of glioblastoma multiforme is limited to a few months after diagnosis if treatment is ignored. Glioblastoma multiforme ( GBM) is the most common and most aggressive type of primary Brain Tumor, accounting for 52% of all primary brain tumor

The main treatment option for single metastatic tumors is surgical removal, followed by radiotherapy and/or chemotherapy. Multiple metastatic tumors are generally treated with radiotherapy and chemotherapy. Stereotactic radiosurgery, such as Gamma Knife radiosurgery, remains a viable option. Stereotactic surgery or stereotaxy is a Minimally-invasive form of surgical intervention which makes use of a three-dimensional Coordinates system Radiosurgery, also known as stereotactic radiotherapy is a Medical procedure which allows non-invasive treatment of benign and malignant conditions avascular malformations Gamma Knife® (or Leksell Gamma Knife®) is a device used to treat Brain tumors with a high dose of Radiation therapy in one day Radiosurgery, also known as stereotactic radiotherapy is a Medical procedure which allows non-invasive treatment of benign and malignant conditions avascular malformations However, the prognosis in such cases is determined by the primary tumor, and it is generally poor.

A shunt operation is used not as a cure but to relieve the symptoms. In Medicine, a shunt is a hole or passage which moves or allows movement of fluid from one part of the body to another [1] The hydrocephalus caused by the blocking drainage of the cerebrospinal fluid can be removed with this operation. Hydrocephalus (pronunciation ˌhaɪˌdɹoʊˈsɛfələs is a term derived from the Greek words "hydro" meaning water and "cephalus" meaning head and this condition Drainage is the natural or artificial removal of surface and sub-surface water from a given area Cerebrospinal fluid ( CSF) Liquor cerebrospinalis, is a clear Bodily fluid that occupies the Subarachnoid space and the Ventricular system

Research to treatment with the Vesicular stomatitis virus

In 2000, researchers at the University of Ottawa, led by John Bell M. For the university in Ottawa Kansas see Ottawa University. The University of Ottawa or Université d'Ottawa in French D. , have discovered that the Vesicular stomatitis virus, or VSV, can infect and kill cancer cells, without affecting healthy cells if coadministered with interferon. Vesicular stomatitis virus (VSV is a Virus in the family Rhabdoviridae; the well-known Rabies virus belongs to the same family ^[11]

The initial discovery of the virus' oncolytic properties were limited to only a few types of cancer. Several independant studies have indentified many more types susceptible to the virus, including glioblastoma multiforme cancer cells, which account for the majority of brain tumors. Glioblastoma multiforme ( GBM) is the most common and most aggressive type of primary Brain Tumor, accounting for 52% of all primary brain tumor

In 2008, researchers at Yale University, led by Dr. Anthony van den Pol, artificially engineered strains of VSV that were less cytotoxic to normal cells. This advance allows administration of the virus without coadministration with interferon. Consequently administration of the virus can be given intravenously or through the olfactory nerve. The olfactory nerve, or cranial nerve I, is the first of twelve Cranial nerves The specialized Olfactory receptor neurons of the olfactory nerve are located In the research, a human brain tumor was implanted into mice brains. A mouse (plural mice) is a small Animal that belongs to one The VSV was injected via their tails and within 3 days all tumor cells were either dead or dying.

Research on virus treatment like this has been conducted for some years, but no other viruses have been shown to be as efficient or specific as the VSV mutant strains. Future research will focus on the risks of this treatment, before it can be applied to humans. ^[12]

See also

• List of notable brain tumor patients

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References

External links

• Samantha Dickson Brain Tumour Trust: research and support in the UK
• SDBTT Astro Fund: research and support for low-grade brain tumours
• Brain and Spinal Tumors: Hope Through Research (National Institute of Neurological Disorders and Stroke)
• Brain Lesion Locator Find Lesions and Differential Diagnosis of Brain Tumors
  
• American Brain Tumor Association
• AFIP HandoutRadiology and Pathology of Astrocytoma
• [2]Children's Brain Tumor Foundation