General Introduction

Brain Tumors


Brain tumors are the growth of abnormal cells and mass formation in the brain. There are benign (non-cancerous) and malignant (cancerous) types of brain tumors. Although the underlying cause of tumor formation is not clear, there are risk factors for some tumors. General risk factors include intense radiation exposure, intensive smoking. A small portion of brain tumors can be seen in people with a family history of genetic syndrome or brain tumors in the family that increases the risk of brain tumors.


Tumors can develop from the brain’s own tissue (primary brain tumors), as well as by the spreading of tumors that are present in any part of the body (secondary brain tumors-metastasis).


 


Brain’s Own Tumors


Primary brain tumors occur either from the brain’s own cells or in glands close to the brain tissue such as meninges, cranial nerves (nerves going out from the brain in the skull), the pituitary gland or the pineal gland.


 


Meningioma


These tumors usually develop from the membranes surrounding the brain and spinal cord. They are usually benign, and rarely malignant. They usually grow slowly over the years and show symptoms. Although most of the time they are located below the skull bone on the surface of the brain, sometimes they can grow in deeper locations of the brain in the skull base.


 


Vestibular Schwannoma


They are usually benign tumors that develop in the nerves that control the balance and hearing in our inner ear. They grow within years. They can cause balance disorder and hearing loss.


 


Glial Tumors (astrocytoma, oligodendroglioma, oligoastrocytoma, astroblastoma, glioblastoma, gliosarcoma)


These group of tumors can be both benign and malignant tumors that develop from astrocyte and oligodendrogliocyte cells in the brain. These tumors can be from graded from 1 to 4. Grade 1 is benign, while grade 4 is the most malignant tumor. Some tumors are always considered as malignant (glioblastoma, gliosarcoma, and others) and some are always considered benign (pilocytic astrocytoma). However, while some tumors are usually benign (meningioma, schwannoma), sometimes they can also have a higher grade and be more malignant. The growth rates of tumors may vary depending on their pathological diagnosis. Patient complaints arising from brain tumors may vary depending on their type, location, and size.


 


 


 


Ependymoma


These tumors can be both in the brain or in the spinal cord. Some of these tumors are benign while some are malignant. This tumor can travel to other parts of the central nervous system via the cerebrospinal fluid and recur.


 


Medulloblastoma


They are the most common malignant brain tumors that are seen in children. These tumors begin in the posterior cavity of the brain and tend to spread throughout the spinal fluid. These tumors are less common in adults.


 


Craniopharyngioma


They are benign tumors which are located near the pituitary gland of the brain that secretes hormones that control various bodily functions. As they grow slowly, they may affect the pituitary gland and other structures near the brain.


 


Choroid Plexus Tumors


They are usually benign tumors that develop in the ventricles, which are fluid-filled cavities of the brain, and are usually seen during childhood.


 


Pituitary Gland Tumors (Pituitary adenomas)


They are mostly benign tumors that develop in the pituitary gland at the base of the brain. These tumors may affect the pituitary hormones and therefore they can show symptoms in many parts of the body. As a result of the growth of these tumors, they can exert pressure on the eye nerves and cause partial or complete blindness.


 


Metastatic tumors


Secondary brain tumors (metastatic tumors) are tumors that develop, as a result of cancer, in other parts of the body and are then spread to the brain. Although secondary brain tumors are frequently seen in people with a history of cancer and are encountered in during follow-ups, sometimes they may be the first sign of a tumor that starts elsewhere in the body. Secondary brain tumors are more common in adults than the brain’s own primary tumors. Although all cancers can spread to the brain, the most common metastatic cancers are as follows: Lung cancer, Breast cancer, Colon cancer, Kidney cancer and Melanoma.


 


 


 


 


SPINAL SURGERY


Lumbar Disc Herniation (Herniated Lumbar Disc)


Herniated disc is a condition where the disc material located between the bones of the spine is damaged, ruptured, fragmented and displaced into the canal and causes compression to the spinal cord and the nerve roots. As a result of this compression, pain, numbness or weakness may be encountered. Symptoms may be seen in waist or leg areas, on the right or left side or on both sides.


Lumbar Narrow Canal (Lumbar Spinal Stenosis)


This very common narrow canal disease (lumbar stenosis) occurs when the structure of the discs, spine joints, and ligaments between the vertebrae deteriorates over time. As the patient gets older, the discs harden, and the bones and joints become thicker and wider. The spinal canal is narrowed by the growth of discs and facet joints. Symptoms show up after this canal, which contains the spinal cord and nerve roots, that make our legs move and feel, narrows down and crushes the nerve structures. This condition is called lumbar narrow canal (lumbar stenosis).


In this disease, colloquially known narrow canal, complaints begin especially when walking. The numbness, tingling, and pain sensation that begins in the legs and feet and patients being forced to stop and rest on their way are among the most important symptoms of narrow canal disease. Especially encountered in older women with weight problems, narrow canal disease can cause damage such as gait disorders and paralysis if not treated.


Narrow canal disease may be seen in three different parts of the spine: the neck, waist, and the back, and it occurs as a result of the aging of the spine. It is usually seen in older ages and is especially common in women who are overweight. Symptoms of the disease in the lower back may often be confused with the herniated disc. Patients who have a numbness, tingling and burning sensation, pain and weakness in the legs and feet should consult a doctor.


Spondylolisthesis


Spondylolisthesis is the sliding of one vertebra on another vertebra. It can often be the result of age-associated degenerative processes in adults. Sometimes it can be seen as a result of hereditary problems or trauma of the spine in younger people. It is usually accompanied by lower back pain. If the shift puts pressure on the nerves, leg pain may occur.


Neck Hernia (Cervical Disc Herniation)


Neck (cervical disc) hernia is the condition where the disc material (pads) located between the cervical vertebrae is ruptured, fragmented and displaced into the canal as a result of aging or trauma, and causes compression to the spinal cord and the nerve roots.


Narrow Canal In The Neck (Cervical Spinal Stenosis)


A narrow canal in the neck (cervical spinal stenosis) is defined as the narrowing of the openings called foramen through which the spinal cord or the nerve roots, which are located in the neck vertebrae, pass. Degenerative changes caused by aging in the spine, deformed large hernias, bone extensions due to calcification, and rheumatic changes may cause the narrowing of the canal in which the spinal cord is located. This narrowing may give out signs by exerting pressure on the nerve roots or the spinal cord.


 


Spinal Cord Stimulation


What Is spinal cord stimulation? To Whom Is It Applied?


The spinal cord stimulation is a system that prevents the patient from feeling pain by stimulating a very thin electrode placed behind the spinal cord. It is especially applied to patients with chronic pain who have had surgery but whose pain persists. It can also be applied to patients who have pain in the legs after spinal cord injury.


Is it possible to eliminate the pain completely or does it only reduce the severity of the pain? The pain is completely eliminated in some patients, while it is reduced in some patients. The goal is to reduce pain by at least 50% with a pain pacemaker.


Spinal Cord Injury and Spinal Cord Paralysis


Every year, thousands of people face spinal cord paralysis as a result of traffic accidents, jumping into the sea or sports injuries. When trauma occurs on the spine, the vertebrae may break or slip. As a result of this fracture or displacement, the spinal cord and nerve tissue inside the spine may be injured. When the spinal cord, which makes our arms and legs move and feel, is injured, paralysis may occur either with full or partial inactivity and numbness.


Spine Tumors


Although spine tumors usually begin elsewhere in the body and reach the spine via blood or lymph circulation, or by directly spreading, tumors that develop from the vertebrae themselves can also be seen in rare occasions. Tumors that develop from the vertebrae are bone tumors that can also occur in other parts of the body. These tumors can be both benign and malignant. Tumors that spread to the spine from elsewhere in the body are usually malignant. Tumors grow towards the spinal canal and cause symptoms of compression on the spinal cord. In addition, tumors can lead to the collapse and fracturing of the vertebrae by holding the vertebral body.


 


To make a decision for the treatment of the patient who is diagnosed with a spinal tumor, the patient’s detailed medical history is required. Patient’s examination and detailed radiological investigation are necessary. Treatment planning can be carried out accurately by determining the tumor type in advance with a biopsy to be performed on the patient.


 


A biopsy is usually performed under general anesthesia and in the operating room. Pathological examination of the tumor is performed by taking a piece from the tumor.


 


Hospitals