A brain tumor is an intracranial solid neoplasm, a tumor (defined as an abnormal growth of cells) within the brain or the central spinal canal.

Some tumors are brain cancers. Brain tumors include all tumors inside the human skull (cranium) or in the central spinal canal.

They are created by an abnormal and uncontrolled cell division, usually in the brain itself, but also in lymphatic tissue, in blood vessels, in the cranial nerves, in the brain envelopes (meninges), skull, pituitary gland, or pineal gland.

Within the brain itself, the involved cells may be neurons or glial cells (which include astrocytes, oligodendrocytes, and ependymal cells).

Brain tumors may also spread from cancers primarily located in other organs (metastatic tumors).

Any brain tumor is inherently serious and life-threatening because of its invasive and infiltrative character in the limited space of the intracranial cavity.

However, brain tumors (even malignant ones) are not invariably fatal, especially lipomas which are inherently benign.

Brain tumors or intracranial neoplasms can be cancerous (malignant) or non-cancerous (benign); however, the definitions of malignant or benign neoplasms differ from those commonly used in other types of cancerous or non-cancerous neoplasms in the body.

Its threat level depends on the combination of factors like the type of tumor, its location, its size and its state of development.

Because the brain is well protected by the skull, the early detection of a brain tumor occurs only when diagnostic tools are directed at the intracranial cavity.

Usually, detection occurs in advanced stages when the presence of the tumor has caused unexplained symptoms.

Primary (true) brain tumors are commonly located in the posterior cranial fossa in children and in the anterior two-thirds of the cerebral hemispheres in adults, although they can affect any part of the brain.

Visibility of signs and symptoms of brain tumors mainly depends on two factors: the tumor size (volume) and tumor location.

The moment that symptoms will become apparent, either to the person or people around him or her (symptom onset) is an important milestone in the course of the diagnosis and treatment of the tumor.

The symptom onset – in the timeline of the development of the neoplasm – depends in many cases, on the nature of the tumor but in many cases is also related to the change of the neoplasm from “benign” (i.e. slow-growing/late symptom onset) to more malignant (fast-growing/early symptom onset).

It might seem strange that despite having a mass in his skull exercising pressure on the brain the patient feels no pain, but as anyone who has suffered a concussion can attest, pain is felt on the outside of the skull and not in the brain itself.

The brain has no nerve sensors in the meninges (outer surface) with which to feel or transmit pain to the brain’s pain center; it cannot signal pain without sensory input. That is why secondary symptoms like those described above should alert doctors to the possible diagnosis of a neoplasm of the brain.

Although there is no specific or singular clinical symptom or sign for any brain tumors, the presence of a combination of symptoms and the lack of corresponding clinical indications of infections or other causes can be an indicator to redirect diagnostic investigation towards the possibility of an intracranial neoplasm.

Brain tumors have similar characteristics and obstacles when it comes to diagnosis and therapy with tumors located elsewhere in the body. However, they create specific issues that follow closely to the properties of the organ they are in.

The diagnosis will often start with an interrogation of the patient to get a clear view of his medical antecedents, and his current symptoms. Clinical and laboratory investigations will serve to exclude infections as the cause of the symptoms.

Examinations in this stage may include the eyes, otolaryngological (or ENT) and/or electrophysiological exams. The use of electroencephalography (EEG) often plays a role in the diagnosis of brain tumors.

Swelling or obstruction of the passage of cerebrospinal fluid (CSF) from the brain may cause (early) signs of increased intracranial pressure which translates clinically into headaches, vomiting, or an altered state of consciousness, and in children changes to the diameter of the skull and bulging of the fontanelles.

More complex symptoms such as endocrine dysfunctions should alarm doctors not to exclude brain tumors.



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