Brain Tumours

Cystic tumour of the 3rd Ventricle

A young lady in her early 30s presented to her GP with a short history of headaches and visual disturbance. Over a longer period of time, she had been investigated for infertility. An MRI scan of the brain revealed a large solid and cystic tumour of the 3rd ventricle. It appeared to be compressing the optic chiasm inferiorly and also causing early obstructive hydrocephalus. Below are representative images from the […]

Recurrent Glioma – an agonizing choice of approach

A 48 year old man had been followed in our clinic for approximately 5 years. He had previously been treated at another institution after being diagnosed with a malignant glioma after suffering from seizures. After his initial presentation with seizures, he had surgical resection of a small tumour of the right frontal region, and then this was followed with radiotherapy and chemotherapy. He made a reasonable recovery from this. On […]

Haemangioblastoma

This 43 male presented with progressive headaches and neck pain over many months. He also described some visual obscuration over that time. He had a CT scan without contrast and was referred for assessment. An MRI scan was performed, showing a large, highly vascular left sided posterior fossa tumour, with obstructive hydrocephalus (figs 1 and 2). Urgent treatment of the hydrocephalus was needed so he proceeded to an endoscopic 3rd […]

Management of Brain Metastasis

Metastatic tumors are the most common neoplasm in the brain, occurring in 24-45% of all cancer patients and accounting for 20% of cancer deaths annually.  These rates are on the increase due to a boost in survival of patients with cancer because of modern therapies along with increased availability of advanced imaging techniques for early detection. Newer therapies such as immunotherapy prolong overall survival in some cancers such as Melanoma […]

The Role of Surgery for Malignant Glioma – Is it all good?

Surgery has an important role in the diagnosis and treatment of patients with most brain tumours, including glioma patients with a suspected brain tumour are usually referred straight to a neurosurgeon for that reason. Traditionally, brain tumour surgery has been a core activity and skill for neurosurgeons, but better outcomes for almost all patients with brain tumours (especially gliomas/GBM/malignant glioma) are achieved when the patient is managed by a neurosurgeon […]

Why doesn’t the immune system work against Brain Cancer?

That is a VERY good question. Why would the body allow tumour cells to grow and destroy the normal brain? Isn’t the immune system supposed to rid us of foreign and destructive material? The immune system certainly is supposed to do this. It a highly evolved and finely tuned system that in general works extremely well. There are checks and balances built into this system which can go wrong – […]

CMV and brain tumours

Cytomegalovirus (CMV) is a common virus in our community. Most adults will show serological evidence of of previous exposure. CMV can cause severe disease, but generally this is only in newborns or in immunosuppressed patients, such as those people having had a transplant. In the last few years, it has become clear that CMV can be identified in brain tumour tissue – both in primary gliomas (glioblastoma, astrocytoma, GBM) and […]

Tumour Treating Fields – A new treatment for Glioblastoma

Malignant gliomas (glioblastoma, GBM) are difficult to treat. Our current methods of treatment –  surgery, radiotherapy and chemotherapy – all help but are ultimately not curative. New treatments are desperately needed. In recent years, a new form of treatment has been developed which may have a role in the future – Tumour Treating Fields (TTFields). TTFields are low intensity, intermediate frequency electric fields that slow cell division therefore inhibit tumour […]

Dexamethasone – the potential downside

Brain tumours often cause swelling in the brain and this swelling makes the pressure effect of the brain tumour worse. Symptoms therefore can be exacerbated – headaches may be worse, or patients can be drowsy or the neurological deficits such as arm and leg weakness are exaggerated. For many years, corticosteroids (typically dexamethasone) have been used to reduce the swelling around brain tumours. Starting dexamethasone can be very effective in controlling […]

Tumour of the brainstem

Ms Ip was a 66 year old lady in good health. She had an MRI brain scan for investigation of dizziness in 2012 and an enhancing lesion on the dorsal aspect of the medulla was observed. It was consistent with a haemangioblastoma, and thought to be incidental to the mild clinical symptoms. Observation was recommended (see figures 1 and 2). She remained stable but a repeat MRI scan in mid-2015 […]

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