Brain tumours like tumours elsewhere occur due to abnormal cell proliferation in the brain. But they differ from other types of tumours in their clinical features and sequel. Some of these tumours are congenital, i.e. present since birth. Radiation, constant use of mobile phones, exposure to radiation in any form, immune deficiency, tobacco and alcohol use are said to be some of the risk factors leading to development of brain tumours. People who are exposed to chemicals like formaldehyde, vinyl chloride, are at high risk of developing brain tumour. Presenting features may be typical or atypical mimicking many other diseases. The tumour may be located in the brain substance or in the coverings of the brain like meningiomas. Lymphomas develop in the lymphatic substance of the brain. Cancers from elsewhere in the body like breast, thyroid, stomach, lungs, e.t.c. can also metastasize to the brain. But tumours from the brain usually do not spread to other parts of the body. Coverings of the brain and the blood brain barrier prevent spread of these tumours to the rest of the body. At times infections of the brain like tuberculosis may also present features like a brain tumour. These tumours can occur at any age but are more common in young children below 8 years or elderly people. Men and white people are more prone to brain tumours as per statistics. Some tumours have greater predilection for particular ages. For example, acoustic neuromas tend to occur more in young adults. Low grade gliomas, ependymomas, teratomas are basically brain tumours of children. Typical symptoms of brain tumour occur because of growth of the tumour in a closed space. There is throbbing headache over the site affected which is more in the morning. This headache increases in duration and severity as the tumour grows. It is associated with vomiting which occurs without nausea. Photophobia, i.e. pain on exposure to light, can also be present. Convulsions can occur if there is irritation of the brain substance by the tumour. Paralysis of one or more limbs, loss of vision or hearing may develop depending on the location of the tumour. Once started, the tumour can spread to other parts of the brain causing further damage. But some patients do not have the typical symptoms. There may just be a vague dull headache which may be mistaken to be caused by stress. Subtle change in behavior, forgetfulness, mild visual disturbances, e.t.c. are atypical features which mimic many other conditions and delay diagnosis of a brain tumour. Onset of convulsions in adults, occurrence of migraine in a person above 40 years, unexplained headache or loss of consciousness, onset of depression without any cause in elderly individuals, should alert one to the possibility of brain tumours. Diagnosis is often delayed as the typical symptoms develop when the tumour is fairly well developed. Diagnosis is made by computed tomography and other imaging techniques. A brain tumour can be benign or malignant. Benign tumour is the one which does not grow rapidly and usually does not spread. On the other hand, a malignant or cancerous tumour grows rapidly and spreads to adjacent areas very soon. Both have potential to cause neurological damage. The benign or malignant nature of a tumour is usually decided by brain biopsy and it helps in deciding the treatment. Usually a tumour which is benign and or has not spread to adjacent organs is operated upon. The operation itself needs surgery in skilled hands as there is a high risk of damage to the brain substance during surgery. Chemotherapy and radiotherapy are other treatment options used. All these modes of treatment are associated with unpleasant sequel. For example chemotherapy usually causes loss of hair which is very uncomfortable for the sufferer. Therefore even if there is a doubt, a person should undergo all tests possible to exclude a brain tumour. Once diagnosed, both the family and the patient need a lot of counselling and reassurance. They have to be explained that brain tumour usually does not kill a person but troubles by causing neurological problems. rachna212002@yahoo.co.uk
