Diagnosis in Brain Tumors

Common complaints and symptoms which are seen in patients:

  1. Headache (the most frequent complaint)
  2. Nausea and vomiting, balance disorder
  3. Seizures (local or include the whole body)
  4. Speech, visual and hearing disorders
  5. Strength loss in hands and/or feet
  6. Paralysis in different types and loss of feel and sense
  7. Urinary and fecal incontinence etc.

Diagnosis: When patients consult to doctors with such complaints the following are usually done to diagnose patients after consultation and if there is a doubt about brain tumor:

  1. Neurologic Examination: First, mental functions, coordination, and speech are tested. Then, cranial nerve functions such as vision, hearing, face-tongue movements are examined. Strength (motor) and sensory examination are done. Then it may require to examine reflex, balance and other functions. Difficulty in one or more areas can give you clues about the part of your brain that may be affected by a brain tumor.
  2. Imaging Methods: Magnetic Resonance Imaging (MRI) is usually the desired examination of suspected brain tumors. MRI is often diagnostic. In some patients, intravenous contrast injection may be required when imaging (contrast-enhanced MRI). The aim here is to allow the drug to be more easily distinguishable from normal brain tissue as a result of the increased intake of the drug by tumor tissue. This will work in tumors which are similar to the normal brain tissue of MR image. With MR spectroscopy, types of tumors can be estimated by looking inside the density of a molecule in the tumor. Functional MRI examines the location of specific centers such as the speech center and body-moving centers (motor centers) and their relationship with the tumor. Specific MRI methods such as tractography, perfusion MRI, diffusion MRI may also be necessary for the treatment plan, as it may be useful in diagnosing. Sometimes, additional examinations such as brain tomography may be necessary together with MRI. Tomography shows calcification in the tumor. Brain tomography can be used for diagnostic purposes as well as for the planning of surgery in tumors associated with skulls, as it shows bone structures better and detailed.
  3. Examinations Which are Required for Cancer Diagnosis in Other Parts of the Body: If your brain tumor is suspected of splashing (metastasis) elsewhere in the body, then additional tests such as PET-BT, scintigraphy and whole-body MRI may be required to detect those tumors.

Biopsy: The sampling and testing of abnormal tissue in the brain. It can be done with a thin needle through an open or small hole like brain surgery. A stereotactic needle biopsy can be performed for very sensitive areas that can be damaged by a broader operation in the brain or for brain tumor areas which are difficult to reach. In this process, after the small hole has been drilled in the skull, coordinates are drawn to the determined point on the pre-drawn brain MRI and BT and the tissue sample is taken from this point for pathology. Tissue samples which are taken are examined under a microscope in pathology laboratories and they give information about the tumor type, benign or malignant, necessary treatments and prognosis.