Meningiomas usually are benign tumors which arise from the meninges of the brain. They represent 15-20% of all tumors in the brain, and most commonly occur in middle-aged adults, more often in women. Meningiomas are slow growing with distinct borders and usually grow quite large before causing symptoms.
Acoustic Neuromas are benign tumors of the nerve of hearing. They almost always affect one side only. They account for less than 5% of all intracranial tumors. Common symptoms are one-sided hearing loss and buzzing or ringing in the ear. Dizziness is sometimes present. There are other, rarer symptoms.
Pituitary adenomas are benign, slow growing tumors of the pituitary gland. They represent about 10% of all intracranial tumors.
Pituitary adenomas are classified as secreting or non-secreting. These tumors often invade the optic chiasm. The most common symptoms of optic chiasm involvement are visual loss and headache. Secreting tumors are categorized by the hormone secreted. Pituitary tumors are commonly treated with endocrine (chemo) therapy, radiation therapy and full or partial surgical removal.
image courtesy of Elekta
AVM’s are neurovascular malformations (which also include AV fistulae and cavernous malformations) in the brain. These conditions may be silently present for decades before bleeding or causing neurological symptoms. They are more commonly diagnosed in younger patients, but may be diagnosed at any age. Historically these conditions were treated with sometimes difficult and risky surgery. Successful outcomes were highly dependent on the skill and experience of the neurosurgeon. Since the 1970’s, tens of thousands of patients with AVMs have been successfully treated with Gamma Knife procedures. In recent years, new non-invasive endovascular treatments have begun to be used to partially destroy AVM’s. However, these procedures (“embolizations”) require multiple procedures and usually must be combined with additional surgery or radiosurgery for complete success. However, with Gamma Knife, one treatment often is all that is needed.
Trigeminal Neuralgia (TN) (sometimes called “tic”) is a debilitating facial pain usually affecting one side of the face. It is characterized by electrical, stabbing pains that occur in clusters at unpredictable time intervals. Some patients report dozens of pain attacks daily. The condition often defies proper diagnosis and is sometimes confused with dental pain. The definitive cause of TN is not well-understood, but is generally believed to be the result of an artery in the brain constantly pounding on the Fifth cranial nerve (the trigeminal nerve), resulting in an electrical phenomenon sending pain signals to the brain stem. It is typically diagnosed at a later age in life and sometimes resists proper diagnosis for decades.
Metastatic brain tumors form from cancer cells that began elsewhere in the body
and have traveled to the brain. Cancers that frequently spread to the brain include:
Metastatic brain tumors may appear anywhere in the brain including the covering (dura).
Melanoma is rapidly on the increase in the American population. When it is confined to its original site on the body, melanoma can be surgically removed in much the same way as other more benign skin lesions. However, in its malignant form, melanoma becomes an aggressive invader, metastasizing throughout the body to major organs and bone. The most devastating consequence of this spread occurs when the cancer spreads to the brain. In the past, patients with this diagnosis had little hope of surviving more than a few weeks or months. Surgery could not stop the further spread of disease in the brain and whole brain radiation had little effect on this highly radio- resistant pathology.
Early attempts at controlling the metastases were limited to treating a small number of lesions – typically only one to three with no further treatment offered. Control rates were high with radiosurgery; however the procedure could not stop the disease from occurring in other locations in the brain. There was little, if any survival advantage and there was even less interest in repeatedly bringing in patients for additional MRI scans and frequent Gamma Knife treatments.
In addition to the conditions listed above, we also treat numerous other types of tumors and abnormalities in the brain; many do not fall into specific categories.