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Brain Tumors: Types, Symptoms, Diagnosis & Treatment

A brain tumor is an abnormal growth of cells within the skull. They are classified by origin, behavior, and grade (WHO I-IV).

Major Categories

  • Primary: Arise from brain tissue (gliomas, meningiomas, pituitary adenomas, medulloblastomas, schwannomas).
  • Metastatic (secondary): Spread from lung, breast, melanoma, renal, colon. **More common than primary.**
  • Benign vs. Malignant: Benign (slow-growing, circumscribed, non-invasive) can still be fatal by compression. Malignant (infiltrative, high mitotic activity, necrosis).

Common Symptoms (Location-Dependent)

  • Headaches (worse AM, Valsalva, progressive).
  • Seizures (new-onset in adult = tumor until proven otherwise).
  • Focal deficits: Weakness, sensory loss, aphasia, visual field cuts.
  • Cognitive/personality changes (frontal).
  • Nausea/vomiting (increased ICP).
  • Gait ataxia (posterior fossa).
  • Endocrine dysfunction (pituitary/sellar).

Diagnosis

  1. MRI with contrast (gold standard).
  2. CT (acute hemorrhage, bone, if MRI contraindicated).
  3. Biopsy/resection for histology, molecular markers (IDH, 1p/19q, MGMT, H3K27M, BRAF).
  4. LP for CSF cytology (pineal, meningeal, metastatic).

Treatment

  • Surgery: Maximal safe resection (5-ALA fluorescence, awake mapping).
  • Radiation: EBRT, SRS/SRT (Gamma Knife, CyberKnife), proton therapy.
  • Chemo: Temozolomide (glioblastoma), PCV (oligodendroglioma), targeted (bevacizumab, larotrectinib, dabrafenib/trametinib).
  • TTFields: Optune (glioblastoma).
  • Supportive: Dexamethasone (edema), antiepileptics, rehab.

Prognosis

Varies widely: Pilocytic astrocytoma (WHO I) → 90%+ 10-yr survival. Glioblastoma (WHO IV) → median 15-18 months. Molecular markers now drive classification and therapy more than histology alone.

Multidisciplinary neuro-oncology teams optimize outcomes.

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