What is brain tumour?

A brain tumour is an abnormal growth of tissue in the brain.  This abnormal growth is the consequence of the uncontrolled multiplication of certain cells in the brain.  As these cells multiply progressively, the tumour emerges. Broadly speaking, there are two kinds of tumours:

Benign Brain Tumours: These tumours are slow-growing and restrict themselves to the brain, that this, they do not migrate to other parts of the body.  However even this category of tumours may need to be removed if the growing mass affects proximate healthy tissue, increases the pressure within the brain and otherwise affects the functioning of this vital organ.  Some of the common benign brain tumours are: pituitary adenoma, craniopharyngioma, meningiomas, neurocytoma, epidermoid cysts,  haemangioma, etc

Malignant  Brain Tumours: These tumours grow much faster than benign brain tumours.  Primary brain tumours, which originate within the brain, may also metastasise (spread) to other parts of the body. Some examples of the common malignant brain tumours are: High Grade Astrocytoma/Glioma, lymphoma, ependymoma, medulloblastoma, etc

Most brain tumours, however, have their origin in primary tumours that originate in other parts of the body such as the liver, the breast, etc.


Craniotomy/Brain Tumour Excision Surgery in India

If the neurologist and the neurosurgeon decide that a brain tumour, benign or malignant, needs to be treated, the most likely approach is surgery.

The surgery for removal of a tumour in the brain is called craniotomy.  The surgery is mostly done under general anaesthesia, except in those situations where brain mapping-which requires the inputs of the patient during the surgery-is involved.  Brain tumour excision surgery can take several hours. A great amount of planning happens prior to the brain surgery in India with extensive use of imaging techniques.


What happens during Craniotomy/Brain Tumour Excision Surgery in India:

Under general anaesthesia, the surgeon makes an incision along the planned line, exposes the skull and uses a special tool to cut away a section of the skull.  The objective of the surgery would be the total removal of the tumour.  However in many cases, the surgeon may be compelled to limit the excision in order to avoid damage to surrounding healthy tissue and compromising on brain function.  This situation happens when the tumour is in an inaccessible part of the brain. In extreme cases, the surgeon may also have to be content with removing a small portion of the tumour for pathological analysis.  In all cases, it is standard practice to send tumour tissue for a biopsy.  The objective of such analysis is to obtain an understanding of the specific nature of the tumour, so that subsequent treatment by way of chemotherapy or radiotherapy can be appropriately targeted.

In some cases of malignant tumours, the surgeon may also decide to deploy polymer chips at the tumour site in order to achieve concentrated local delivery of chemotherapy.


High-tech imaging in Brain Surgery in India

Leading hospitals in India use extremely sophisticated surgery navigation.  The sophisticated imaging and mapping technology enables a very close identification of tumour location.  This facilitates very precise planning of the incision to avoid/minimise trauma to healthy brain tissue in the course of the surgery.  The objective is also to maximise tumour removal to the extent possible.  Stereotactic techniques, wherein imaging is done using 3-axis, also allows for a very high degree of precision while planning treatment.


Hospital stay following brain surgery in India:

Patients would normally need to stay in hospital for about a week following craniotomy  It is usual for patients to spend at least a day or two in ICU for monitoring vitals before they shift to standard rooms for recuperation.


Supplementary lines of treatment:

If complete excision of a malignant tumour was not possible during surgery, it may be necessary for the patient to also undergo chemotherapy or radiotherapy.