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.