PRIMARY BRAIN TUMORS
( Tumors that originate in the brain or from structures adjacent to the brain)

GLIOMA
These primary brain tumors originate in brain tissue. Metastatic brain tumors spread to the brain tissue through the blood stream predominately. Gliomas are often designated as benign or malignant types although further subtypes are generally determined after biopsy tissue is evaluated by the neuropathologist. The treatments vary based on the clinical condition of the patient and the growth potential of the tumor type. The effects of the tumor vary based on the area of the brain involved and can also include seizures or headaches or symptoms of increased intracranial pressure from the mass effect of the tumor and surrounding cerebral edema. MRI scans generally clearly defne the tumor and the area of the brain involved and can be used to follow the growth of the tumor and side effects of edema or hydrocephalus. Surgery is often performed to remove or at least biopsy the tumor using stereotactic techniques to precisely localize the tumor within the skull. Radiation therapy or chemotherapy are often utilized in the treatment of the malignant gliomas. Surgical implantation of chemotherapy wafers directly on the tumor surface can be considered especially for recurrent malignant glioblastoma multiforme tumors. Tumor protocols have also included treatment by infecting the cerebral gliomas first with a virus and then following surgery, giving anti-viral drugs The tumor mass can be reduced by the effects of drugs on infected cells and the inflammatory response of the brain against the infected tissue. Gamma Knife stereotactic radiation can be used as a primary treatment if the diagnosis is already determined or for small recurrent tumor re-growth. The gold standard is usually surgical resection of all tumor microscopically followed by radiation therapy. Decadron is often given for 3 days or more pre-operatively to reduce cerebral edema. All the options required careful clinical individual evaluation by your physician and discussion of the treatment alternatives.

MENINGIOMA
(read below)