Brain Tumour: From 2 Different Sources
An abnormal growth in or on the brain. Tumours may be primary growths arising directly from tissues within the skull or metastases (secondary growths) that have spread from tumours elsewhere in the body. The cause of primary brain tumours is not known. About 60 per cent are gliomas (frequently cancerous), which arise from the brain tissue. Other primary tumours include meningiomas, acoustic neuromas, and pituitary tumours. Most of these tumours are noncancerous, but their size can cause local damage. Certain types of primary brain tumour mainly affect children. These include 2 types of glioma called medulloblastoma and cerebellar astrocytoma. Primary brain tumours virtually never spread (metastasize) outside the central nervous system.
Symptoms include muscle weakness, loss of vision, or other sensory disturbances, speech difficulties, and epileptic seizures. Increased pressure within the skull can cause headache, visual disturbances, vomiting, and impaired mental functioning. Hydrocephalus may occur.
When possible, primary tumours are removed by surgery after opening the skull (see craniotomy).
In cases where a tumour cannot be completely removed, as much as possible of it will be cut away to relieve pressure.
For primary and secondary tumours, radiotherapy or anticancer drugs may also be given.
Corticosteroid drugs are often prescribed temporarily to reduce the size of a tumour and associated brain swelling.
see cerebral tumour.
A mass or swelling. The lump can be a neoplasm (benign or malignant) or a tumour can be a mass due to an infection or inflammation.... tumour
A functional, semi-permeable membrane separating the brain and cerebrospinal ?uid from the blood. It allows small and lipid-soluble molecules to pass freely but is impermeable to large or ionised molecules and cells.... blood brain barrier
Also called nephroblastoma. This is the commonest kidney tumour in infancy. It is a malignant tumour, which occurs in around one per 10,000 live births. The survival rate with modern treatment (removal of the kidney followed by radiotherapy and chemotherapy) is now around 80 per cent.... wilms’ tumour
The irreversible cessation of all functions of the brain, including the brainstem. (See also death.)... brain death
A growth comprised of immature sperm cells in the male testis or of immature ova in the female ovary. A seminoma is one type of germ cell tumour (see testis, cancer of).... germ cell tumour
Cerebral hyperemia. See Poe, Edgar Allen... brain fever
Most blows to the head cause no loss of consciousness and no brain injury. If someone is knocked out for a minute or two, there has been a brief disturbance of the brain cells (concussion); usually there are no after-effects. Most patients so affected leave hospital within 1–3 days, have no organic signs, and recover and return quickly to work without further complaints.
Severe head injuries cause unconsciousness for hours or many days, followed by loss of memory before and after that period of unconsciousness. The skull may be fractured; there may be ?ts in the ?rst week; and there may develop a blood clot in the brain (intracerebral haematoma) or within the membranes covering the brain (extradural and subdural haematomata). These clots compress the brain, and the pressure inside the skull – intracranial pressure – rises with urgent, life-threatening consequences. They are identi?ed by neurologists and neurosurgeons, con?rmed by brain scans (see COMPUTED TOMOGRAPHY; MRI), and require urgent surgical removal. Recovery may be complete, or in very severe cases can be marred by physical disabilities, EPILEPSY, and by changes in intelligence, rational judgement and behaviour. Symptoms generally improve in the ?rst two years.
A minority of those with minor head injuries have complaints and disabilities which seem disproportionate to the injury sustained. Referred to as the post-traumatic syndrome, this is not a diagnostic entity. The complaints are headaches, forgetfulness, irritability, slowness, poor concentration, fatigue, dizziness (usually not vertigo), intolerance of alcohol, light and noise, loss of interests and initiative, DEPRESSION, anxiety, and impaired LIBIDO. Reassurance and return to light work help these symptoms to disappear, in most cases within three months. Psychological illness and unresolved compensation-claims feature in many with implacable complaints.
People who have had brain injuries, and their relatives, can obtain help and advice from Headwat and from www.neuro.pmr.vcu.edu and www.biausa.org... brain injuries
See BRAIN INJURIES.... concussion of the brain
A neoplasm with a number of different cell types undergoing cancerous change.... mixed tumour
See: ANTI-NEOPLASTICS. ... anti-tumours
Usually associated with some loss of sensation and power in another part of the body. Taste, smell, hearing, sight and movement may be affected. The following are some of the disorders that may affect the brain. Each has a separate entry in this book.
Abscess, Alzheimer’s Disease, anoxia (oxygen starvation), coma, concussion, haemorrhage, Down’s syndrome, epilepsy, tumour, hydrocephalus (water on the brain), meningitis, multiple sclerosis, stroke (rupture of blood vessel), spina bifida, syphilis (general paralysis of the insane), sleepy sickness.
Poor circulation through the brain due to hardening of the arteries: Ginkgo, Ginseng. Ginseng stimulates the hypothalmic/pituitary axis of the brain and favourably influences its relationship with the adrenal glands.
Congestion of the brain – Cowslip (Boerwicke). Irritability of brain and spine – Hops. Oats. Inflammation of the brain (encephalitis) as in viral infection, poliomyelitis, rabies, sleepy sickness, etc: Echinacea, Passion flower, Skullcap and Lobelia. Gelsemium acts as a powerful relaxant in the hands of a practitioner: Tincture BPC (1973): dose 0.3ml.
Brain storm from hysteria, locomotor ataxia, etc – Liquid Extract Lobelia: 5ml teaspoon in water when necessary (Dr Jentzsch, 1915, Ellingwood) Supplement with Zinc, Vitamins C and E.
Blood clot, thrombosis: Yarrow. Neurasthenia: Oats, Basil, Hops.
Brain fag and jet-lag: Chamomile, Skullcap, Oats, Ginseng, Ginkgo.
Tumour may be present years before manifesting: Goldenseal.
Mental state: depression, anxiety, schizophrenia.
Tea. Formula. Skullcap, Gotu Kola and German Chamomile; equal parts. 1 heaped teaspoon to each cup water gently simmered 10 minutes. Strain. 1 cup thrice daily.
Unspecified tensive state. Formula. Tinctures. Hops 1; Passion flower 2; Valerian 2. Dose: 2 teaspoons thrice daily until diagnosis is concluded.
Unspecified torpor. Formula. Tinctures. Ginseng 1; Kola 1; Capsicum quarter. 2 teaspoons in water thrice daily until diagnosis is concluded.
Brain weakness in the elderly: Ginkgo. See: ALZHEIMER’S DISEASE.
Fluid on the brain: see HYDROCEPHALUS.
Abscess of the brain: see ABSCESS.
Brain restoratives. Black Haw, True Unicorn root, Galangal, Oats, Oatstraw, False Unicorn root, Kola, Hops. Vitamin B6. Magnesium.
Cerebral thrombosis. See entry.
Note: Cold water may help victims to survive: rapid loss of body heat protects the brain. (Child Health Department, University of Wales)
Treatment by or in liaison with general medical practitioner or hospital specialist. ... brain disorders
Cancerous or noncancerous tumours in the adrenal glands, usually causing excess secretion of hormones. Adrenal tumours are rare. Tumours of the adrenal cortex may secrete aldosterone, causing primary aldosteronism, or hydrocortisone, causing Cushing’s syndrome. Tumours of the medulla may cause excess secretion of adrenaline and noradrenaline. Two types of tumour affect the medulla: phaeochromocytoma and neuroblastoma, which affects children. These tumours cause intermittent hypertension and sweating attacks. Surgical removal of a tumour usually cures these conditions.... adrenal tumours
A growth composed of cells that produce various hormones. These cells, amine precursor uptake and decarboxylation (APUD) cells, occur in different parts of the body. Some tumours of the thyroid gland, pancreas, and lungs are cell tumours, as are a carcinoid tumour (see carcinoid syndrome) and phaeochromocytoma (a type of adrenal tumour).... apud cell tumour
See brain syndrome, organic.... brain failure
Bleeding within or around the brain that is caused either by injury or by spontaneous rupture of a blood vessel. There are 4 possible types of brain haemorrhage: subdural, extradural, subarachnoid, and intracerebral. Extradural and subdural haemorrhages are usually the result of a blow to the head (see head injury). Subarachnoid and intracerebral haemorrhages usually occur spontaneously due to rupture of aneurysms or small blood vessels in the brain.... brain haemorrhage
These consist either of expanding masses (lumps or tumours), or of areas of shrinkage (atrophy) due to degeneration, or to loss of blood supply, usually from blockage of an artery.
Tumours All masses cause varying combinations of headache and vomiting – symptoms of raised pressure within the inexpansible bony box formed by the skull; general or localised epileptic ?ts; weakness of limbs or disordered speech; and varied mental changes. Tumours may be primary, arising in the brain, or secondary deposits from tumours arising in the lung, breast or other organs. Some brain tumours are benign and curable by surgery: examples include meningiomas and pituitary tumours. The symptoms depend on the size and situation of the mass. Abscesses or blood clots (see HAEMATOMA) on the surface or within the brain may resemble tumours; some are removable. Gliomas ( see GLIOMA) are primary malignant tumours arising in the glial tissue (see GLIA) which despite surgery, chemotherapy and radiotherapy usually have a bad prognosis, though some astrocytomas and oligodendronogliomas are of low-grade malignancy. A promising line of research in the US (in the animal-testing stage in 2000) suggests that the ability of stem cells from normal brain tissue to ‘home in’ on gliomal cells can be turned to advantage. The stem cells were chemically manipulated to carry a poisonous compound (5-?uorouracil) to the gliomal cells and kill them, without damaging normal cells. Around 80 per cent of the cancerous cells in the experiments were destroyed in this way.
Clinical examination and brain scanning (CT, or COMPUTED TOMOGRAPHY; magnetic resonance imaging (MRI) and functional MRI) are safe, accurate methods of demonstrating the tumour, its size, position and treatability.
Strokes When a blood vessel, usually an artery, is blocked by a clot, thrombus or embolism, the local area of the brain fed by that artery is damaged (see STROKE). The resulting infarct (softening) causes a stroke. The cells die and a patch of brain tissue shrinks. The obstruction in the blood vessel may be in a small artery in the brain, or in a larger artery in the neck. Aspirin and other anti-clotting drugs reduce recurrent attacks, and a small number of people bene?t if a narrowed neck artery is cleaned out by an operation – endarterectomy. Similar symptoms develop abruptly if a blood vessel bursts, causing a cerebral haemorrhage. The symptoms of a stroke are sudden weakness or paralysis of the arm and leg of the opposite side to the damaged area of brain (HEMIPARESIS), and sometimes loss of half of the ?eld of vision to one side (HEMIANOPIA). The speech area is in the left side of the brain controlling language in right-handed people. In 60 per cent of lefthanders the speech area is on the left side, and in 40 per cent on the right side. If the speech area is damaged, diffculties both in understanding words, and in saying them, develops (see DYSPHASIA).
Degenerations (atrophy) For reasons often unknown, various groups of nerve cells degenerate prematurely. The illness resulting is determined by which groups of nerve cells are affected. If those in the deep basal ganglia are affected, a movement disorder occurs, such as Parkinson’s disease, hereditary Huntington’s chorea, or, in children with birth defects of the brain, athetosis and dystonias. Modern drugs, such as DOPAMINE drugs in PARKINSONISM, and other treatments can improve the symptoms and reduce the disabilities of some of these diseases.
Drugs and injury Alcohol in excess, the abuse of many sedative drugs and arti?cial brain stimulants – such as cocaine, LSD and heroin (see DEPENDENCE) – can damage the brain; the effects can be reversible in early cases. Severe head injury can cause localised or di?use brain damage (see HEAD INJURY).
Cerebral palsy Damage to the brain in children can occur in the uterus during pregnancy, or can result from rare hereditary and genetic diseases, or can occur during labour and delivery. Severe neurological illness in the early months of life can also cause this condition in which sti? spastic limbs, movement disorders and speech defects are common. Some of these children are learning-disabled.
Dementias In older people a di?use loss of cells, mainly at the front of the brain, causes ALZHEIMER’S DISEASE – the main feature being loss of memory, attention and reasoned judgement (dementia). This affects about 5 per cent of the over-80s, but is not simply due to ageing processes. Most patients require routine tests and brain scanning to indicate other, treatable causes of dementia.
Response to current treatments is poor, but promising lines of treatment are under development. Like Parkinsonism, Alzheimer’s disease progresses slowly over many years. It is uncommon for these diseases to run in families. Multiple strokes can cause dementia, as can some organic disorders such as cirrhosis of the liver.
Infections in the brain are uncommon. Viruses such as measles, mumps, herpes, human immunode?ciency virus and enteroviruses may cause ENCEPHALITIS – a di?use in?ammation (see also AIDS/HIV).
Bacteria or viruses may infect the membrane covering the brain, causing MENINGITIS. Viral meningitis is normally a mild, self-limiting infection lasting only a few days; however, bacterial meningitis – caused by meningococcal groups B and C, pneumococcus, and (now rarely) haemophilus – is a life-threatening condition. Antibiotics have allowed a cure or good control of symptoms in most cases of meningitis, but early diagnosis is essential. Severe headaches, fever, vomiting and increasing sleepiness are the principal symptoms which demand urgent advice from the doctor, and usually admission to hospital. Group B meningococcus is the commonest of the bacterial infections, but Group C causes more deaths. A vaccine against the latter has been developed and has reduced the incidence of cases by 75 per cent.
If infection spreads from an unusually serious sinusitis or from a chronically infected middle ear, or from a penetrating injury of the skull, an abscess may slowly develop. Brain abscesses cause insidious drowsiness, headaches, and at a late stage, weakness of the limbs or loss of speech; a high temperature is seldom present. Early diagnosis, con?rmed by brain scanning, is followed by antibiotics and surgery in hospital, but the outcome is good in only half of affected patients.
Cerebral oedema Swelling of the brain can occur after injury, due to engorgement of blood vessels or an increase in the volume of the extravascular brain tissue due to abnormal uptake of water by the damaged grey (neurons) matter and white (nerve ?bres) matter. This latter phenomenon is called cerebral oedema and can seriously affect the functioning of the brain. It is a particularly dangerous complication following injury because sometimes an unconscious person whose brain is damaged may seem to be recovering after a few hours, only to have a major relapse. This may be the result of a slow haemorrhage from damaged blood vessels raising intracranial pressure, or because of oedema of the brain tissue in the area surrounding the injury. Such a development is potentially lethal and requires urgent specialist treatment to alleviate the rising intracranial pressure: osmotic agents (see OSMOSIS) such as mannitol or frusemide are given intravenously to remove the excess water from the brain and to lower intracranial pressure, buying time for de?nitive investigation of the cranial damage.... brain, diseases of
See dermoid cyst.... dermoid tumour
Cancerous or noncancerous growths in the intestine. Cancerous tumours commonly affect the large intestine (see colon, cancer of; rectum, cancer of); the small intestine is only rarely affected. Lymphomas and carcinoid tumours (leading to carcinoid syndrome) may sometimes develop in the intestine; noncancerous tumours include polyps in the colon, and adenomas, leiomyomas, lipomas, and angiomas in the small intestine.... intestine, tumours of
Disorder of consciousness, intellect, or mental functioning that is of organic (physical), as opposed to psychiatric, origin. Causes include degenerative diseases, such as Alzheimer’s disease; infections; certain drugs; or the effects of injury, stroke, or tumour. Symptoms range from mild confusion to stupor or coma. They may also include disorientation, memory loss, hallucinations, and delusions (see delirium). In the chronic form, there is a progressive decline in intellect, memory, and behaviour (see dementia). Treatment is more likely to be successful with the acute form. In chronic cases, irreversible brain damage may already have occurred. (See also psychosis.)... brain syndrome, organic
A hypothetical condition thought to account for behavioural and other problems in children for which no physical cause is found. It may be a cause of some learning difficulties, difficulty in concentrating, impulsiveness, and hyperactivity.... minimal brain dysfunction
See brain syndrome, organic.... organic brain syndrome
A growth arising from the tissues that develop into the placenta. The most common type of trophoblastic tumour is a hydatidiform mole. (See also choriocarcinoma.)... trophoblastic tumour
A nonmedical term for hydrocephalus.... water on the brain
A type of kidney cancer, also called nephroblastoma, that occurs mainly in children.... wilms’ tumour
(BNP) see natriuretic peptide.... brain natriuretic peptide
an abnormal multiplication of brain cells. Any tumorous swelling tends to compress or even destroy the healthy brain cells surrounding it and – because of the rigid closed nature of the skull – increases the pressure on the brain tissue. Malignant brain tumours, which are much more common in children than in adults, include *medulloblastomas and *gliomas; these grow rapidly, spreading through the otherwise normal brain tissue and causing progressive neurological disability. Benign tumours, such as *meningiomas, grow slowly and compress the brain tissue. Both benign and malignant tumours commonly cause fits. Benign tumours are often cured by total surgical resection. Malignant tumours may be treated by neurosurgery, chemotherapy, and radiotherapy, but the outcome for most patients remains poor.... cerebral tumour
(DBS) a surgical treatment involving the implantation of a medical device that sends electrical impulses to specific parts of the brain. DBS in selected brain regions can provide benefits for treatment-resistant movement disorders, such as Parkinson’s disease, tremor, and *dystonia.... deep brain stimulation
a rare tumour of fetal remnants of the ovaries or testes. In women it is an aggressive malignant ovarian tumour that develops in adolescence and may secrete alpha-fetoprotein and human chorionic gonadotrophin, which can be used as *tumour markers. It is treated by oophorectomy with adjuvant chemotherapy.... endodermal sinus tumour
(GIST) a rare type of sarcoma arising from the gastrointestinal tract (usually the stomach), characterized by the presence of the receptor c-kit/CD117 on the surface of the tumour cells, which stimulates division of these cells. It displays a wide range of malignant behaviour. Specific treatment is available with *tyrosine kinase inhibitors.... gastrointestinal stromal tumour
see renal cell carcinoma. [P. A. Grawitz (1850–1932), German pathologist]... grawitz tumour
an androgen-producing tumour of the ovary found in older women and often resulting in *virilization. Such tumours are so called as they tend to occur around the area of the ovary where the blood vessels enter (the hilum). They are usually small and are treated by surgical removal, with resolution of most of the symptoms.... hilar cell tumour
a malignant tumour of the thyroid gland that arises from Hürthle (or Askanazy) cells, altered follicular cells of the gland that have large nuclei and stain deeply with eosin (these cells are also found in benign nodules and Hashimoto’s disease). Hürthle cell carcinoma is not as common as papillary, follicular, or anaplastic thyroid carcinomas (see thyroid cancer). [K. W. Hürthle (1860–1945), German histologist]... hürthle cell tumour
any tumour arising in a cell of the pancreatic *islets of Langerhans. These tumours, which include *insulinomas, *glucagonomas, and *somatostatinomas, form one of the two major subclasses of gastrointestinal neuroendocrine tumours, the other being the *carcinoid tumours.... islet cell tumour
see cholangiocarcinoma. [G. Klatskin (20th century), US physician]... klatskin tumour
a rapidly developing malignant growth in one or (more often) both ovaries. It is caused by the *transcoelomic spread of a primary growth in the stomach or intestine, typically an adenocarcinoma. [F. E. Krukenberg]... krukenberg tumour
a tumour of the *interstitial (Leydig) cells of the testis. Such tumours often secrete testosterone, which in prepubertal boys causes *virilization and precocious puberty.... leydig tumour
see haemangioblastoma. [A. Lindau (1892–1958), Swedish pathologist]... lindau’s tumour
any one of a group of neoplasm tumour-like malformations arising from odontogenic tissues or their remnants. The most important example is the *ameloblastoma.... odontogenic tumour
1. an accumulation of fluid (pleural effusion) in the lung in patients with heart failure, which resembles a lung tumour on radiological examination. 2. a swelling in the abdomen or elsewhere, caused by local muscular contraction or the accumulation of gases, that mimics a swelling caused by a tumour.... phantom tumour
an *adenoma of the umbilicus.... raspberry tumour
a small painless nonmalignant swelling in the lower half of the *sternomastoid muscle, appearing a few days after birth. It occurs when the neck of the fetus is in an abnormal position in the uterus, which interferes with the blood supply to the affected muscle, and it is most common after breech births. The tumour may cause a slight tilt of the head towards the tumour and turning of the face to the other side. This can be corrected by physiotherapy aimed at increasing all movements of the body, but without stretching the neck.... sternomastoid tumour
(TBI) injury to the brain due to external force, such as occurs following falls, road traffic accidents, and violence. It is a major cause of death and chronic disability worldwide, especially in young males.... traumatic brain injury
a protein produced by cancer cells. Its presence in the blood can be revealed by means of a simple blood test, aiding the diagnosis of malignant melanoma and other cancers at their earliest – and most treatable – stages of development.... tumour-associated antigen
(TIL) a lymphoid cell that can infiltrate solid tumours. Such cells can be cultured in vitro, in the presence of *interleukin 2, and have been used as vehicles for *tumour necrosis factor in gene therapy trials for cancer.... tumour-infiltrating lymphocyte
a substance produced by a tumour that can be used to aid detection of the tumour and to monitor its size and the effects of treatment. An example is *alpha-fetoprotein, which is used to monitor treatment of malignant *teratomas. See also CA125; CA19-9; carcino-embryonic antigen; human chorionic gonadotrophin.... tumour marker
(TNF) either of two proteins, TNF-? or TNF-?, that function as *cytokines. Produced by macrophages, monocytes, T lymphocytes, and various other cells, they mediate many responses, including inflammation, and have a marked action against tumour cells. Anti-TNF drugs (see cytokine inhibitor) are used in the treatment of several disorders, especially rheumatoid arthritis and ankylosing spondylitis.... tumour necrosis factor
(adenolymphoma) a tumour of the parotid salivary glands, containing epithelial and lymphoid tissues with cystic spaces. [A. S. Warthin (1866–1931), US pathologist]... warthin’s tumour