Dr Vishal Dabare

A brain tumor is an abnormal growth of cells in the brain. Tumors can be primary (originating in the brain) or secondary/metastatic (spread from other organs like lung, breast, or kidney).🔹 Types of Brain Tumors1. Based on OriginPrimary Brain TumorsGliomas (astrocytoma, glioblastoma, oligodendroglioma)MeningiomaPituitary adenomaSchwannoma (e.g., acoustic neuroma)Secondary/Metastatic TumorsSpread from other cancers (lung, breast, melanoma, kidney)2. Based on LocationSupratentorial: Above the tentorium cerebelli; affects cerebrumInfratentorial: Below the tentorium; affects cerebellum & brainstem🔹 Causes / Risk FactorsGenetic mutationsRadiation exposureFamily history (rare)Immunodeficiency (rare)🔹 SymptomsHeadache: Often worse in morning or with Valsalva maneuverNausea and vomitingSeizuresNeurological deficits: Weakness, sensory loss, vision or speech problemsCognitive or personality changesBalance/coordination problems (posterior fossa tumors)

Spine tumors are abnormal growths that develop within or around the spinal cord and vertebrae. They can be primary (originating in the spine) or secondary/metastatic (spread from other organs).🔹 Types of Spine Tumors1. Based on LocationExtradural Tumors – Outside the dura, mostly in vertebrae (e.g., metastasis, multiple myeloma).Intradural-Extramedullary Tumors – Inside dura but outside spinal cord (e.g., meningioma, schwannoma).Intramedullary Tumors – Inside the spinal cord (e.g., ependymoma, astrocytoma).2. Based on OriginPrimary Spine Tumors: Originate in vertebra or spinal cord.Metastatic Tumors: Spread from breast, lung, prostate, kidney, thyroid, or other cancers.🔹 Causes / Risk FactorsGenetic mutations (rare)Prior cancers (breast, lung, prostate, kidney)Age (some tumors more common in children/adults)Unknown for many primary spinal cord tumors🔹 SymptomsPain: Localized or radiating; worse at night or with movement.Neurological deficits: Weakness, numbness, tingling in limbs.Bladder/bowel dysfunction: Late symptom, often indicates cord compression.Spinal deformity / pathological fracture: In vertebral tumors.

Epilepsy surgery is a treatment option for patients whose seizures cannot be controlled with medications (drug-resistant epilepsy). The goal is to remove or disconnect the part of the brain causing seizures while preserving normal brain function.🔹 IndicationsDrug-resistant focal epilepsy (seizures originate from a single brain region)Seizures causing severe disability or injuryStructural abnormalities visible on MRI (cortical dysplasia, tumor, scar)Temporal lobe epilepsy with hippocampal sclerosis🔹 Types of Epilepsy Surgery1. Resective SurgeryAnterior Temporal Lobectomy: Most common; removes seizure focus in temporal lobe.Lesionectomy: Removes a specific lesion causing seizures (tumor, cortical dysplasia).2. Disconnection SurgeryCorpus Callosotomy: Cuts fibers connecting the two hemispheres to prevent spread of seizures.Hemispherectomy / Hemispherotomy: Rare, removes or disconnects one hemisphere; used in severe unilateral epilepsy.3. Neurostimulation / ModulationVagus Nerve Stimulation (VNS): Implanted device stimulates vagus nerve to reduce seizures.Deep Brain Stimulation (DBS): Electrodes in thalamus modulate seizure activity.Responsive Neurostimulation (RNS): Detects abnormal electrical activity and delivers electrical pulses to stop seizures.🔹 Pre-Surgical EvaluationMRI Brain: Identify structural lesion.Video EEG Monitoring: Localize seizure focus.PET/SPECT scans: Assess metabolic activity.Neuropsychological testing: Determine functional areas of brain.Functional MRI / Wada Test: Evaluate speech/memory dominance.🔹 Advantages of SurgeryPotential complete seizure freedom (especially temporal lobe epilepsy).Reduced need for anti-epileptic drugs.Improved quality of life, cognition, and psychosocial function.🔹 Risks / ComplicationsNeurological deficits (speech, motor, memory) depending on location.Infection, bleeding.Seizures may persist (not all patients become seizure-free).Psychological impact.