Chapter 78

Once a sample is obtained, a pathologist examines the tissue under a microscope and writes a pathology report containing an analysis of the brain tissue. Sometimes the pathologist may not be able to make an exact diagnosis. This may be because more than one grade of tumor cells exists within the same tumor. In some cases, the tissue may be sent to another institution for additional analysis.

A pathology report contains the analysis of brain tissue taken at the time of a craniotomy or needle biopsy. A pathologist examines the tissue under a microscope. Further tests or analysis may be performed on the tumor tissue. Then the pathologist will write a pathology report, which provides the information to make a diagnosis of the tumor type.

Sometimes the pathologist may not be able to make an exact diagnosis. This may be because more than one grade of tumor cells exists within the same tumor. If cells of only one grade are removed and classified during a biopsy, it is possible that the tumor grade will be misdiagnosed. In your case, the sample obtained via a needle biopsy, and according to the pathological report, is non-malignant, but we have to perform a surgery to remove it.

Chapter 77

Different parts of the brain control different functions, so symptoms will vary depending on the tumor’s location. A brain tumor diagnosis usually involves several steps, which can include a neurological examination, brain scan(s) and/or a biopsy. A neurological examination is done to measure your nervous system and physical and mental alertness. If responses to the exam are not normal, we do a scan or refer the patient to a neurologist or neurosurgeon, who will then order a scan.

A brain scan compiles an image of the brain by photographing it from various angles. Some types of scans use a contrast agent (or contrast dye), which helps the doctor to see the difference between normal and abnormal brain tissue. The contrast agent is injected into a vein and flows into brain tissue. Abnormal or diseased brain tissue absorbs more dye than normal, healthy tissue.

And Biopsy is a surgical procedure in which a sample of tissue is taken from the tumor site and examined under a microscope. The biopsy will provide information on types of abnormal cells present in the tumor. The purpose of a biopsy is to discover the type and grade of a tumor. A biopsy is the most accurate method of obtaining a diagnosis. An open biopsy is done during a craniotomy. A craniotomy involves removing a piece of the skull in order to get access to the brain.

After the tumor is resected (completely removed) or debulked (partially removed), the bone is usually put back into place. A closed biopsy (also called stereotactic or needle biopsy) may be performed when the tumor is in an area of the brain that is difficult to reach. In a closed biopsy, the neurosurgeon drills a small hole into the skull and passes a narrow, hollow needle into the tumor to remove a sample of tissue.

Chapter 76

Dr.Martin started talking, “You might have come across some medical jargons and they might have left you wondering, what it means, are they talking about me? Etc. Well, I shall start by explaining to you the functions of the brain and that should give you an insight on what is going on and the procedures and options you will be facing” and he continued with a detailed explanation.

The brain controls memory and learning, senses -hearing, sight, smell, taste, and touch, and emotion. It also controls other parts of the body, including muscles, organs, and blood vessels. Adult brain tumor is a disease in which cancerous – malignant cells begin to grow in the tissues of the brain. This overview covers tumors that start in the brain -primary brain tumors. Often cancer found in the brain has started somewhere else in the body and has spread (metastasized) to the brain. This is called brain metastasi.

As you have experienced, frequent and common symptoms are headaches, vomiting, or difficulty walking or speaking. We performed a computed tomographic (CT) scan that I am holding in my hand as you can see and he held it up in the light and continued. We also did a magnetic resonance imaging (MRI) scan, which uses magnetic waves to make a picture of the brain. The chance of recovery (prognosis) and choice of treatment depend on the type of brain tumor and the patient's general state of health and in your case; you seem to be in good shape.

Chapter 75

After about twenty minutes, Dr.Martin walked in, he was in his early sixties, about five seven, square face, white hair, slight belly with a kaki pant and a white shirt with his name tag adhering to it and a pen with a golden hinge, a Rolex watch, indicating his wealth and a reassuring smile, followed by Dr.Collins, with some x-Rays and CT scans and a folder in her hand. He introduced himself to everyone in the room and pulled a chair towards him and enquired how Pryag was doing that morning.

Akshar, felt a bit of unease staying in the room when Dr.Martin was there to discuss the patients history, he just met him, so he excused himself and walked towards the corridor. Pryag introduced Diya to him and after some chit-chat; he opened his history chart and started to discuss his case. His casual enquires had put her at ease, she enquired if he was going to be ok. Sensing the concern in her voice, Dr.Collins replied that he is in the best hands in a reassuring tone.

Before she could finish her pager went off and she excused herself, handed over the papers that she was holding onto and left the room. There was something about Dr.Martin, the Diya felt reassuring, even though he hadn’t started briefing his case, she wondered if Pryag felt the same way and as if he were reading her thoughts, he reached forward for her hand and held it tight and gave a pat and smiled at her.