Brain Tumour Biopsy

Symptoms | Treatments

What is

Causes and Risk Factors

Treatment

What is - Brain Tumour Biopsy

A brain tumour is an abnormal growth of cells present from the brain or its nerves or its coverings
It can arise from cells inside the brain/nerves/brain coverings, and can be cancerous or noncancerous
It can also be a cancerous growth that has spread to the brain from a cancer present in another part of the body

In some brain cancer cases, removal of some tumour tissue (biopsy) to confirm its nature and its suitability for further treatment (radiation therapy, chemotherapy) may be all that can be done
This biopsy is done with MRI-guidance using a special metal frame (frame-based) or a computerised neuronavigation system (frameless)
It can be done under Local or General anaesthesia
A small scalp incision is needed
A small opening, the size of a 10 cent coin, is made in the skull bone
A biopsy needle is inserted to take out samples of the brain tumour tissue

Brain Tumour Biopsy Condition and Treatments

Risks of general anaesthesia: Heart attack, lung problems, allergy to anaesthetic drugs, etc
Blockage of leg veins
Chest infection
Urinary tract infection

Patients are expected to have same level of alertness as before procedure. They are not expected to be more awake or more drowsy
The scalp incision is covered with a small dressing
Histology results take a week or longer to be ready

Observation i.e. non intervention: Proper treatment cannot be given as type of tumour is unknown. Repeat MRI/CT then biopsy if tumour has grown bigger
Radiation therapy/chemotherapy: Given usually when nature of tumour is known, because of risks

This is a brain operation wherein the surgeon makes an opening in the skull bone and removes the brain tumour
It may be done under General or Local anaesthesia
A scalp incision is made over the area of the brain tumour
An opening will be made in the skull bone
The outer covering of the brain is opened to expose the brain and the tumour
Symptomatic relief from mass effect
Improve neurological condition
Decrease tumour size of the tumour to improve results of adjuvant therapy (radiation therapy, chemotherapy)
Histological diagnosis: No sampling error
Complete cure (benign) or improved survival (malignant)
The tumour is separated from normal brain and other important structures such as blood vessels and nerves, then removed
In cancerous tumours, tumour cells often spreads beyond tumour boundaries into adjacent “normal” brain, so it would not be possible to remove all of it
The aim is to remove as much tumour as is safely possible, without injuring the normal brain and other important structures
Tumour may be left
- If stuck to important brain structures, blood vessels, or nerves,
- If there is excessive bleeding or brain swelling during the operation
Second operation or other measures e.g. Radiotherapy/chemotherapy may be required to treat the remnant tumour

Injury to the brainstem
- Impaired consciousness
- Possible need for ventilator support
Injury to cranial nerves
- Double vision
- Facial numbness, facial asymmetry
- Loss of hearing
- Difficulty swallowing
- Slurring of speech
Hydrocephalus
- May need to undergo a ventriculo-peritoneal shunt operation
Inability to speak (cerebellar mutism)
Involuntary head movements (titubation)
Difficulty with walking and balance