Brainstem Tumours: Management and Treatment

Brainstem tumours are a significant concern in both the pediatric and adult populations, with brainstem glioma (BSG) being the most common type. The brainstem is a critical part of the brain, controlling vital functions such as breathing, swallowing, and heartbeat. Because of its crucial role, surgery in this area is often not possible, as it can damage neuronal structures essential for these functions.

Understanding Brainstem Glioma (BSG)

Brainstem gliomas tend to occur primarily in children and adolescents, with 77% of cases found in individuals under 20 years old. These tumours are among the three most common brain tumours in the pediatric population. Due to their invasive nature, symptoms usually do not appear until the tumour has grown extensively.

Symptoms and Signs

Patients with brainstem tumours often present with the following symptoms:

  1. Difficulty in walking: This is usually one of the first signs noticed.
  2. Headache: Persistent headaches that can be severe and worsen over time.
  3. Nausea and vomiting: Often related to increased intracranial pressure.
  4. Double vision: Caused by pressure on the cranial nerves.
  5. Facial deviation (weakness): Weakness on one side of the face.
  6. Progressive weakness and numbness: Affecting all four limbs as the disease advances.
  7. Hydrocephalus: Occurs in about 60% of patients due to cerebrospinal fluid (CSF) obstruction, leading to increased intracranial pressure.
  8. Raised intracranial pressure: Symptoms include headache and vomiting.
  9. Poor feeding and malnourishment: Especially in children under 2 years old.

Diagnosis and Treatment

Diagnosis:

  1. MRI Brain with Contrast: This is the investigation of choice. MRI can differentiate between malignant and benign tumours and provide detailed imaging of the tumour.
  2. CT Imaging: While less detailed than MRI, CT scans can still provide useful information.
  3. Stereotactic Biopsy: For most patients, a CT or MRI-guided stereotactic biopsy is necessary to determine the tumour’s stage and grade.

Treatment:

  1. Microsurgical Excision: Possible only for a small group of patients where the tumour projects into the ventricular surface (exophytic tumours). However, this is rare due to the risk of damaging vital brainstem structures.
  2. Radiation Therapy: Particularly for malignant tumours, this can be an effective treatment. The use of radiation therapy depends on the patient’s age and the tumour’s characteristics.
  3. Chemotherapy: Often used in conjunction with radiation therapy to manage malignant tumours.
  4. Symptom Management: Addressing symptoms like hydrocephalus with procedures to relieve CSF obstruction can improve quality of life.

Prognosis

The prognosis for brainstem tumours varies. Children and adults with low-grade tumours generally have a better prognosis and longer survival rates compared to those with malignant tumours. However, the prognosis remains guarded due to the tumour’s location and potential complications.

Comprehensive Care at Hannah Joseph Hospital

At Hannah Joseph Hospital, we understand the complexities and challenges associated with brainstem tumours. Our multidisciplinary team of specialists is dedicated to providing comprehensive and compassionate care for our patients. We utilize the latest diagnostic tools and treatment protocols to ensure the best possible outcomes.

Why Choose Hannah Joseph Hospital?

  1. Expertise: Our team includes highly experienced neurosurgeons, oncologists, and radiologists who specialize in treating brainstem tumours.
  2. Advanced Technology: We use state-of-the-art imaging and surgical equipment to diagnose and treat our patients effectively.
  3. Personalized Care: Each patient’s treatment plan is tailored to their specific needs, ensuring they receive the most appropriate and effective care.
  4. Support Services: We offer extensive support services, including nutritional counseling, physical therapy, and psychological support, to help patients and their families cope with the diagnosis and treatment.

Trust Hannah Joseph Hospital for Your Care

Brainstem tumours present significant challenges, but at Hannah Joseph Hospital, we are committed to providing the highest standard of care. Our dedicated team works tirelessly to offer hope and improve the quality of life for our patients. If you or a loved one is facing a brainstem tumour, contact Hannah Joseph Hospital today to learn more about our comprehensive treatment options and support services. Your health and well-being are our top priorities.