SYMPTOMS


  • Headache

  • Nausea and/or vomiting

  • Convulsive seizure

  • Limb weakness

  • Uncoordinated gait

  • Alteration of sensitivity

  • Double vision or vision disorder

  • Difficulty with language

  • Deafness

  • Paralysis or reduced sensitivity of the face

  • Difficulty swallowing

DIAGNOSIS

CT SCAN OF THE BRAIN

The brain CT is usually the first test to be carried out. It gives rise to the initial suspicion of a brain tumour because it allows the lesion to be seen, albeit imprecisely.

MAGNETIC RESONANCE IMAGING OF THE BRAIN

La Resonancia Magnética cerebral es la prueba principal y más precisa. Hoy día permite, no solo obtener una imagen muy anatómica del tumor cerebral, sino también estudiar que características tiene. Podemos localizar el tumor, saber su tamaño, si tiene características de más o menos agresividad y si esta en relación con zonas cerebrales que tienen una función importante (sobretodo motora o de lenguaje). Además se suele realizar una secuencia de Resonancia Magnética de alta definición para utilizarla como mapa durante la cirugía y a través de un recurso llamado neuronavegación.

Magnetic resonance imaging of the brain is the primary and most accurate test. Not only does it generate a very anatomical image of the brain tumour, but also enables its characteristics to be studied. We can locate the tumour, determine its size and its aggressiveness, and if it is related to areas of the brain that have an important function (especially motor or language). In addition, a sequence of high-resolution MRI to be used as a map during surgery is usually performed, through a resource called neuronavigation.

WHOLE-BODY PET SCAN

This is used to identify any brain lesions originating in another area of the body, as well as the location of the primary tumour. It is usually used to assess the spread of a cancer if metastasis is suspected.

THORACOABDOMINAL CT SCAN

This is equivalent to a whole-body PET scan but it is somewhat less effective.

BLOOD TEST WITH TUMOUR MARKERS

This blood test is used to complete the study of a cancer with suspected metastasis. Elevated levels of these markers may indicate a primary tumour and its possible location.

TREATMENTS

In most cases, if the brain tumour is not very widespread or the patient's conditions do not allow it, surgery is the main treatment. The role of surgery is twofold: to obtain tissue for accurate tumour diagnosis (biopsy); and to remove as much of the tumour as possible.

Depending on the type of brain tumour, other treatments can be added to make the surgery more radical. These treatments are radiotherapy and chemotherapy. They must be appropriate for the type of tumour in accordance with international protocols. In some cases, such as lymphomas, they may constitute the primary treatment ahead of surgery.

BRAIN TUMOUR SURGERY

In brain tumour surgery, perfect planning is vital. At barnaclínic+, we use the most advanced technological resources to remove the maximum volume of tumour causing the least damage. These resources are: neuronavigation (a system that can locate any brain structure with a high degree of precision), intraoperative MRI (a very useful instrument that shows throughout the operation how much tumour remains to be removed and from which areas), robotic visualisation platform (facilitates better visualisation during surgery and access to complex areas) and neurophysiological monitoring (a resource that helps the surgeon to identify which areas of the brain can be removed and which cannot owing to the important function they perform, primarily movement or language).

The surgery is usually performed under general anaesthesia. In some cases, where it is beneficial to examine language function while the brain tumour is being removed, the patient can be operated on while awake with local anaesthesia. During awake brain surgery, the patient does not feel any pain and is simply asked to cooperate throughout the short procedure of removing a tumour from a location close to the language area. During the rest of the surgery, the patient is deeply sedated.

From a technical perspective, brain tumour surgery consists of making a window in the bone to access the lesion as directly as possible and to avoid causing damage. Using an operating microscope and with very precise removal tools, the brain tumour is gradually removed to the extent that the area and function allow.

When finished, the different layers (meninges, bone, skin) are closed. Drains are sometimes placed under the skin to prevent haematoma.

After the surgery, the patient is moved to the ICU for 24 hours. The following day, if there are no complications, the patient will then be moved to their room to slowly recover for 5 to 6 days.

Following detailed analysis, the diagnosis of the extracted tissue is obtained 7 to 10 days after the surgery. Subsequent treatment will be based on the findings of this diagnosis.

Professionals

Josep González Sánchez

Neurosurgeon expert in brain tumors, acoustic neuroma and spine pathology

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