What Are the Symptoms of a Brain Tumor in Adults? : Some tumors have no symptoms until they are quite large and then cause a serious, rapid decline in health.

Symptoms of brain tumors vary according to the type of tumor and the location. Because different areas of the brain control different functions of the body, where the tumor lies affects the way symptoms are manifested.

Some tumors have no symptoms until they are quite large and then cause a serious, rapid decline in health. Other tumors may have symptoms that develop slowly.

A common initial symptom of a brain tumor is headaches. Often, they don't respond to the usual headache remedies. Keep in mind that most headaches are unrelated to brain tumors.

Other symptoms include:

·         Seizures

·         Changes in speech or hearing

·         Changes in vision

·         Balance problems

·         Problems with walking

·         Numbness or tingling in the arms or legs

·         Problems with memory

·         Personality changes

·         Inability to concentrate

·         Weakness in one part of the body

It's important to keep in mind that these symptoms can be caused by a number of different conditions. Don't assume you have a brain tumor just because you experience some of them. Check with your doctor.

How Are Brain Tumors Diagnosed?

To diagnose a brain tumor, the doctor starts by asking questions about your symptoms and taking a personal and family health history. Then he or she performs a physical exam, including a neurological exam. If there's reason to suspect a brain tumor, the doctor may request one or more of the following tests:

·      Imaging studies such as a CT(CAT) scan or MRI to see detailed images of the brain

·     Angiogram or MRA, which involve the use of dye and X-rays of blood vessels in the brain to look for signs of a tumor or abnormal blood vessels

The doctor may also ask for a biopsy to determine whether or not the tumor is cancer. A tissue sample is removed from the brain either during surgery to remove the tumor or with a needle inserted through a small hole drilled into the skull before treatment is started. The sample is then sent to a lab for testing.

HOW TO TREAT BRAIN TUMORS

• Tumors near the surface of the brain may be surgically removed. In many cases, however, it is only possible to remove a portion of a tumor, since taking it all out would cause unacceptable amounts of brain damage. Still, removing even part of it may afford a period of improvement by relieving pressure within the cranium.
• Tumors deep within the brain may be treated with microsurgery, laser surgery, or radiation therapy.
• For malignant primary tumors, surgery may be followed with radiation or chemotherapy. Surgery may also be preceded by radiation.
• Your doctor may prescribe corticosteroids to reduce swelling of brain tissue, anticonvulsant drugs to control seizures, and pain relievers.

Treatment for brain tumors is based on many factors, such as:

• Your age, overall health, and medical history
• The type, location, and size of the tumor
• How likely the tumor is to spread or recur
• Your tolerance for specific medications, procedures, or therapies

Treatment for these symptoms may include:

• Antiseizure/Antiepileptic Drugs (AEDs)
• Steroids
• Surgery

Often, low-grade tumors (grade I and II), which are not aggressive, are treated with watchful monitoring or surgery alone. Though all tumors are monitored with repeat scans, grade II tumors are watched more closely after surgery and over time to make sure there is no recurrence.

Higher grade tumors (grade III and IV), which are malignant and can grow quickly, are more difficult to remove and require additional treatments beyond surgery, such as radiation, chemotherapy, or a clinical trial if one is available. Microscopic tumor cells can remain after surgery and will eventually grow back. All treatments, therefore, are intended to prolong and improve life for as long as possible.

Additional treatment options for high-grade tumors include:

• Radiation therapy: X-rays and other forms of radiation can destroy tumor cells or delay tumor growth.
• Chemotherapy: The use of drugs to kill rapidly dividing cells. It can be taken orally or intravenously.
• Targeted therapy: The focus on a specific element of a cell, such as molecules or pathways required for cell growth, in order to use them as a target.

Vagus Nerve Stimulator for Epilepsy : Advanced Epilepsy Treatment Options Available in India

There are several ways to treat epilepsy. How well each treatment works varies from one person to another. Vagus Nerve Stimulation therapy is a form of treatment for people with epilepsy whose seizures are not controlled with medication.

Vagus nerve stimulation (VNS Therapy) is designed to prevent seizures by sending regular, mild pulses of electrical energy to the brain via the vagus nerve. These pulses are supplied by a device something like a pacemaker.

·         The VNS device is sometimes referred to as a "pacemaker for the brain." It is placed under the skin on the chest wall and a wire runs from it to the vagus nerve in the neck.

·         The vagus nerve is part of the autonomic nervous system, which controls functions of the body that are not under voluntary control, such as the heart rate. The vagus nerve passes through the neck as it travels between the chest and abdomen and the lower part of the brain.

What is the surgery like?

·         The surgeon first makes an incision along the outer side of the chest on the left side, and the device is implanted under the skin. A second incision is made horizontally in the lower neck, along a crease of skin, and the wire from the stimulator is wound around the vagus nerve in the left side of the neck. The brain itself is not involved in the surgery.

·         The device (also called an implant) is a flat, round battery, about the size of a silver dollar—that is, about an inch and a half (4 cm) across—and 10 to 13 millimeters thick, depending on the model used. Newer models may be somewhat smaller.

·         The procedure usually lasts about 50 to 90 minutes with the patient under general anesthesia. Usually the person can go home later the same day. Sometimes you may need to stay overnight in the hospital for observation.  

How is VNS used?

·      The neurologist (or licensed professional) programs the strength and timing of the impulses according to each patient's needs. The settings can be programmed and changed by placing a wand over the generator on the left side of the chest. The wand is connected to a handheld computer.

·         For all patients, the device is programmed to go on (give stimulation) for a certain period (for example, 7 seconds or 30 seconds) and then to go off (stop stimulation) for another period (for example, 14 seconds or 5 minutes). The device is set to give stimulation at regular intervals during the day, usually with 30 seconds of stimulation alternating with 5 minutes of no stimulation. The patient is usually not aware that it's operating.

·         Holding a special magnet near the implanted device (generator) triggers the device to deliver another burst of stimulation, outside of the programmed intervals. For people with warnings (auras) before their seizures, activating the stimulator with the magnet when the warning occurs may help to stop the seizure.

·         Settings (also called stimulation parameters) set by the neurologist typically include a stimulation amplitude of 1.0 to 3.0 mA (milliamperes), a stimulation frequency of 20 - 30 Hz (hertz), and a pulse width of 130 - 500 microseconds. By adjusting these settings, the doctor not only may be able to control more of the patient's seizures, but often can also relieve side effects. One study, for instance, found that changing the pulse width eliminated pain that some patients were experiencing.

·         The battery for the stimulator lasts approximately 5-10 years, depending on the settings used.

What can VNStherapy do during a seizure?

Some people have a warning or aura which is a simple focal (or 'simple partial') seizure that tells them that they are going to have a further seizure. When this happens, they can pass a special magnet over the stimulator to give extra stimulation. This may stop the aura from developing into another seizure or may reduce how long it takes to recover afterwards.

The magnet can be worn on their wrist like a watch or on their belt. For people who have no warning before a seizure, someone else could use the magnet when a seizure happens.

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Advanced Stereotactic Radiosurgery Hospitals in India

Stereotactic Radiosurgery Hospitals in India

Advanced imaging technique now developed to enable Neurosurgeons with intra-operative MRI to aid in the removal of complex and hard-to-access brain tumors during surgery. This new technique relies on a powerful computer system, which assists the surgeon in precisely localizing a lesion, in planning each step of the procedure on the computer screen, and in calculating the ideal access to the tumour before the operation. This is particularly useful in reaching a tumour located deep inside the brain, areas traditionally considered to be difficult to reach. During the procedure, the computer tracks instrument movement with an extremely high precision, providing the surgeon with total control inside the brain at all times using "real-time" imaging. The surgeon can also check if the tumor has been removed as planned. This improves the outlook for the patient. At Our world class hospitals in India we have also begun to use functional image-guidance for patients undergoing stereotactic radiosurgery. The surgeons are highly qualified for stereotactic radiosurgery at the Indian hospitals and give their best for the satisfaction of the patients. Stereotactic radiosurgery is a highly precise form of radiation therapy used primarily to treat tumors and other abnormalities of the brain. There have been considerable differences in cost between the countries like USA, UK, Canada & South Africa as compared to India when it comes to medical treatment. Gamma knife radiosurgery involves four phases: placement of the head frame, imaging of tumor location, computerized dose planning, and radiation delivery. You can also estimate the cost of some common treatments, which are based on average treatment cost of various hospitals & clinics. Patient can evaluate the kind of savings they can do by taking decision of traveling for their treatments like stereotactic radiosurgery at Indian hospitals Stereotactic radiosurgery is a non-surgical procedure that uses highly focused x-rays to treat certain types of tumors, inoperable lesions and as a post-operative treatment to eliminate any leftover tumor tissue or to obliterate abnormal blood vessels in congenital arteriovernous malformations. The treatment involves the delivery of a single high-dose—or sometimes smaller, multiple doses—of radiation beams that converge on the specific area of the brain where the tumor or other abnormality resides.  Using a helmet-like device that keeps the head completely still and three-dimensional computer-aided planning software, stereotactic radiosurgery minimizes the amount of radiation to healthy brain tissue. It is an important alternative to invasive surgery, especially for tumors and blood vessel abnormalities located deep within or close to vital areas of the brain. Radiosurgery is used to treat many types of brain tumors, both benign or malignant and primary or metastatic. Additionally, radiosurgery is used to treat arteriovenous malformations (AVMs), a tangle of expanded blood vessels that disrupts normal blood flow in the brain and is the leading cause of stroke in young people. Although stereotactic radiosurgery is often completed in a one-day session, physicians sometimes recommend a fractionated treatment, in which treatments are given over a period of days or weeks. This is referred to as stereotactic radiotherapy. It works in the same way as other forms of radiation treatment. It does not actually remove the tumor; rather, it distorts the DNA of tumor cells. As a result, these cells lose their ability to reproduce.  Following the treatment, benign tumors usually shrink over a period of 18 months to two years. Malignant and metastatic tumors may shrink more rapidly, even within a couple of months. When treated with radiosurgery, arteriovenous malformations (AVMs) begin to thicken and close off.

Treatment for Parkinson's Disease, Chronic Pain, Tremor and Dystonia- Deep Brain Stimulation (DBS) at Best Neurosurgery Hospital in India

Endovascular neurosurgery, is the field of medicine that combines neurosurgery with interventional neuro- radiology and treats the diseases of blood vessels of the brain and spine. This is a minimally invasive technique which entails using catheters and embolic agents or clotting agents rather than open surgeries.

The procedures are done in angiographic suite (located in the x-ray department), rather than the operating room and is done within the blood vessels using catheters to fill blood vessel abnormalities with particles, polymers or stents.

Endo vascular neuro surgery treats a variety of cerebro vascular diseases which are untreatable through conventional surgery such as:

• Stroke
• Aneurysms
• Arterio-venous malformations
• IArterial stenosis
• Dural arterio-venous fistulas
• Vascular Tumours
• Carotid Cavernous sinus fistulae
• Cerebral revascularization after clotting
• Vasospastic arteries
• 
  

Advantages of Endovascular Neurosurgery/ Interventional Neuroradiology

The most important advantage of the endovascular approach for the treatment of aneurysms, AVMs and tumors of the brain is one, they can be treated, because sometimes they are considered inoperable or too risky to be operated and thus the patient goes without treatment. Endovascular neurosurgery is the procedure of choice in following patients:

• 
  
• Old age
• High risk patients with diabetes and heart disease
• Patients with contraindication for surgery or anaesthesia

Second, craniotomy or opening of the skull is avoided and thus the procedure is done through minimal invasive technique. 

This means:

• 
  

Minimal damage to the normal brain tissue
Almost no mortality
Minimal chances of complications
No brain or spinal cord tissue manipulation
No scarring, pain and least discomfort to the patient
No blood loss and need for blood transfusion
Short hospital stay and fast return to normal activities
Acute stroke patients can be treated even many hours after the stroke.
Can be used to stabilize the bones and reduce pain in patients with specific types of spinal fractures such as compression fractures and fractures caused by osteoporosis.

Why should you choose to get Neurology & Endovascular Neurosurgery in India?

·         Indian doctors are known all over the world for their skill and knowledge and have the experience of studying and working at the best neuron surgery hospitals in the world.

·         Most advanced Technology Infrastructure - Blood Bank with 24 hour apharesis facility, advanced laboratory and microbiology (infection control) support, advanced cardiology, DSA and interventional radiology, portable and colour ultra-sonology, Liver Fibro-scan, 64 slice CT scanner, 3 T MRI, PET-CT and nephrology (including 24 hour dialysis and CVVHD).

·         Neurosurgery Hospitals in India are equipped with the latest and high end technology.

·         Cost of epilepsy surgery in India at best brain surgery hospitals in India is very low as compared to the cost at best hospitals in America or UK with the same level of care and services.

Deep Brain Stimulation, Parkinson Surgery, Tremor, Dystonia, OCD Treatment at World Best Hospital in India

World-class Hospital with dedicated Neurosurgery and Neurology ICUs and centres of Specialisation for brain tumours, spinal disorders, stroke, epilepsy, movement disorders and headache.

Most Advanced Technology like Brain Suite, Biplane Neuroendovascular Angiography, Synergy S Linac System, S-7 Navigation System, Endoscopic Neurosurgery Theatre, 3 Tesla MRI, 256 slice CT scan, PET scan.

 Low Cost Treatment package which includes Airport Pick up and Drop from Airport in India, Hospital Stay, Testing/Screening, Deep Brain Stimulation Treatment, Consultations with Specialist Doctors , Nursing care, Surgeon Fee, Medicines and Consumables.

Experienced Team of professionals having a specialist Neurologist (Movement Disorder specialist), Specialist Neurosurgeon, Neuroradiologist, Physiotherapist and Dietary specialists who provide high-quality care

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Some people with metastatic brain tumors don't show any symptoms... : MRI Guided Brain Tumor Surgery in India

What Is It?

A metastatic brain tumor is cancer that has spread (metastasized) from another part of the body to the brain. It is also called a secondary tumor, lesion or brain metastasis (plural: metastases). In contrast, a primary brain tumor starts in the brain, not in another part of the body.

A tumor is an abnormal mass of tissue. It occurs when cells divide more than they should or don't die when they should.

Cancers that spread to the brain can originate in any part of the body. The original tumor is called the primary tumor. Metastatic brain tumors most commonly originate in the lung, breast, skin, colon, and kidney. A very aggressive form of skin cancer called melanoma often spreads to the brain.

Brain metastases occur when cancer cells break away from a primary tumor. They travel to the brain, usually through the bloodstream. These cancer cells may settle in the brain and continue growing. Sometimes only one secondary brain tumor occurs. But in many cases there are multiple lesions.

The brain is a complex organ enclosed in the skull. Among other things, it serves as the body's center of

• thought
• memory
• emotion
• speech
• vision
• hearing
• movement.

Symptoms

The signs and symptoms of secondary brain tumors depend on their size and location. This is because different parts of the brain control different functions.

As a tumor grows, it can press against or destroy normal brain tissue. It can also increase pressure inside the skull.

Signs and symptoms of brain metastases include

• headaches
• seizures
• visual changes, such as double vision
• lack of energy and/or sleepiness
• vomiting
• changes in mood, behavior, or personality
• weakness in parts of the body
• trouble speaking or hearing
• problems with memory or mental ability
• loss of balance or coordination.

These symptoms are not necessarily signs of brain metastases. But it is important to contact your doctor if you experience any of them.

Some people with metastatic brain tumors don't show any symptoms. However, over time, the brain metastases will continue to grow, eventually causing symptoms.

Diagnosis

The first step in diagnosis is usually a physical exam. Your doctor will check for general signs of disease. He or she will also ask about your health habits and past illnesses and treatments.

The following tests and procedures may be used to determine whether you have cancer that has spread to your brain.

Neurological and visual exams. These tests assess the your mental and physical abilities, including

• alertness
• muscle strength
• coordination
• reflexes
• response to pain
• eyesight

Tumor marker test. A sample of blood, urine, or tissue is taken. Levels of certain substances that may indicate the presence of cancer are measured.

Imaging tests:

• Computed tomography (CT) scan. An x-ray camera rotates around the body. It makes detailed, cross-sectional images of the brain.
• Magnetic resonance imaging (MRI). Radio waves and strong magnets produce detailed pictures of the brain. MRI is better than CT at finding metastatic brain tumors.
• Positron emission tomography (PET) scan. Radioactive glucose (sugar) is injected into the patient's vein. A rotating scanner highlights areas where cells are consuming the glucose. (Cancer cells use more glucose than normal cells.) PET scans may be used before or after treatment.

Lumbar puncture (spinal tap). Assuming it can be done safely, the doctor may want to remove cerebral spinal fluid from the lower back with a needle in some cases. The fluid is then checked for cancer cells.

Angiogram. A contrast dye is injected into the bloodstream and x-rays are taken. This allows the doctor to examine blood vessels and blood flow in the brain. It may identify blockages such as tumors. However, this procedure is less common than in the past because MRI can often provide the same information.

Biopsy. A small piece of tumor tissue is removed for examination. The tumor tissue may be tested for certain substances that provoke an immune response. It will also be analyzed for changes in the cells and their genetic material.

Biopsy can be done using a needle inserted through a hole in the skull. Or it may be done during surgery to remove a tumor.

Sometimes a biopsy can't be done safely because of the tumor location. In this case, the doctor uses imaging and other tests to make the diagnosis.

Sometimes the primary cancer is discovered after the patient is diagnosed with metastatic brain tumors. If brain lesions are the first sign of cancer, various imaging tests may be done to search for the primary tumor

MRI Guided Brain Tumor Surgery in India

MRI Guided Brain Tumor Surgery is an advanced imaging treatment technique developed to enable neurosurgeons with intra-operative MRI to aid in the removal of complex and difficult-to-access brain tumors during surgery. The technique involves use of a powerful computer system that precisely helps neurosurgeon locate a lesion, plan each step of the procedure on computer screen and find out the ideal access to the tumor before performing the operation.

The technique is particularly helpful in treating a tumor that has difficult accessibility such as it is located deep inside the brain. During the procedure, the instrument movement is tracked very precisely by the computer providing surgeon with total control inside the brain with the help of real-time imaging. The technique also helps the surgeon to check if the tumor has been removed.

The Brain Suite has two main parts. There is a high-intensity MRI scanner integrated with an image-guided surgical system. The MRI scanner has a wide-bore opening allowing a patient to lie on his or her side. Previously, tumors that could only be accessed from the side of the skull were not easy to scan. This special MRI system lets doctors repeat scans during the operation to get more accurate information on the location, shape and size of the tumor. This minimizes problems associated with brain tumors shifting during excision.

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