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MENINGIOMA : This is a common benign ( non-cancerous) tumor arising from the covering layer ( Dura) of the brain and spinal cord. The tumor grows slowly over a period of months to years to cause symptoms in a patient. The symptoms vary according to the location and size of the tumor. In the brain the common presentation may be long standing dull headache, seizure (fits), giddiness, loss of power or sensation on either side of the body. Sometimes the presentation is in form of behavioral/personality changes and may range from forgetfulness, apathy and memory problems. In the spinal cord the usual presentation is change of gait and weakness in the limbs. Meningiomas are slightly more common in the females. The diagnosis is done after doing CT scan or MRI scan of the brain or spinal cord. Small (<1-2 cm) incidentally detected tumors can be observed and treated non-operatively. The symptomatic or larger tumors need operation. The surgery is done by meticulously exposing the tumor, separating it from the underlying brain and removing the portion of the dura from where the tumor arises. The excised tumor is sent for special tests ( histopathology, IHC, MIB, ) and is further studied to understand its subtypes and possibilty of recurrence. The removal of Dura may not be possible in all cases and so such patients require close follow up over the next few years .
Pituitary Tumors - Surgery for tumors arising from the pituitary gland . the pituitary gland lies at the base of the brain in a small bony impression called as the sella. The pituitary gland is responsible for the overall control of hormones regulating the various bodily functions ( thyroid, adrenals, gonads-ovaries & testes). Tumors arising from the pituitary gland can present with hormonal disturbances, eyesight problems (reduction in visual field)and other non-specific problems like headaches or giddiness. All these problems can arise slowly or may manifest suddenly due to bleeding inside the pituitary gland( pituitary apoplexy). Surgery is needed for tumors which are not responsive to medications or if the tumor is causing pressure on the optic nerves giving rise to visual problems. Surgery for pituitary adenomas is most commonly performed through the nostril with an endoscope or microscope. Patients need hospital stay for 4-5 days approximately. close monitoring of hormones is required in the post operative period.
Spinal tumors are relatively common problems seen by a Neurosurgeon. Tumors in the spine can start from the cervical (neck portion) spine to the lumbar spine (lower back). The tumors mostly arise inside the spinal canal from the nerve sheath (neurinomas) or arise from the covering of the spinal cord (meningiomas). Rarely they may arise within the spinal cord substance (ependymoma, astrocytoma). These tumors may present as pain, tingling sensations in hands or legs, weakness, change of gait or problems of bowel/bladder. Most of the tumors can be safely excised and a permanent cure attained.