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Brain Tumors |
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Series 1. Low Grade Glioma |
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| This particular tumour was a low grade glioma that was deep within the brain. Nevertheless, it was removed through a burr hole type incision and the postoperative scan showed no residual disease. |  |
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| At the CMIN most craniotomies are performed by shaving very little hair, through very small openings and with minimal tissue trauma. |  |
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| Brain tumours can be primary, like this one, or secondary. They can grow from the brain itself, like this one, or other structures within the cranium or skull. Sometimes their borders are obvious, but unfortunately, often they are not readily distinguishable from the normal brain. |  |
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Series 2. Primary Meningioma |
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| Unfortunately, there are some tumours that cannot be removed through a limited opening. Indeed, at the CMIN, although a minimally invasive approach is encouraged, surgery needs to be maximally effective. This particular tumour is a meningioma, which grows from the lining of the brain. For best results, the lining from which they arise needs to be removed along with the tumour, hence the need to expose the entire origin of the tumour. |  |
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| This surgery obviously requires a large incision and an equally large skull opening. |  |
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| This post-op scan shows the meningioma completely removed. This particular patient had temporary weakness of both legs but within 3 months had made a complete recovery. |  |
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Series 3. Malignant Glioma |
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This is the pre-op scan of a 64 year old man who had a malignant glioma partially removed. He was not able to tolerate the postoperative radiotherapy because of raised pressure within his head and was therefore given palliative treatment only. He then approached The Centre asking for a second opinion and was offered radical resection. After a minimally invasive craniotomy and radical resection he tolerated radiotherapy and is now alive and free of recurrence 18 months after treatment. There were no operative complications. |
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| This is the post-op scan 14 months after his surgery at the Centre. |  |
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Series 4. Pituitary Adenoma |
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| This patient presented with visual deterioration from pressure of the tumour on the overlying visual pathways (optic chiasm). |  |
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| This is the MRI of the same patient after removal of the tumour. The patient was discharged from hospital the day after surgery with no complications and no post-operative pain or discomfort. |  |
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Series 5. Acoustic Neuroma |
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| This is the scan of a 30 year old surgeon who presented with unilateral hearing loss. |  |
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| This is the same patient's scan after total resection of the tumour. He was discharged from hospital 3 days after surgery and had NO facial nerve weakness. He returned to full-time work 2 weeks later. |  |
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Series 5. Tumours of the Third Ventricle |
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| The third ventricle is that part of the brain that lies almost exactly in the middle of the brain. It is part of the ventricular system which contains cerebrospinal fluid (CSF) and is part of an intricate system of fluid channels. Blockage of these channels causes an excessive build-up of fluid called hydrocephalus. The most common tumour that occurs within the third ventricle is a colloid cyst. The management of these benign tumours is controversial when they present as incidental findings, but when they cause obstruction of the CSF, most neurosurgeons would recommend removal either endoscopically or open. The difference between these 2 techniques is quite impressive. When performed endoscopically, patients require a small incision, minimal brain trauma, less post-operative pain and discomfort and less complications. Unfortunately, the endoscopic technique is not always applicable. Other tumours of the third ventricle are juvenile pilocytic astrocytomas, central neurocytomas, germ cell tumours, craniopharyngiomas and other more malignant gliomas. A specific and rare tumour that arises from the walls of the third ventricle is the HYPOTHALAMIC GLIOMA. This is a slow growing, sometimes non-growing (hamartoma) tumour that causes very unique symptoms. One of these is GELASTIC SEIZURES which cause the patient to break into spontaneous laughter. Other symptoms are obesity from loss of satiety, premature onset of puberty in young children, spontaneous rage attacks and excessive tiredness. In the past, treatment options were limited. However, through ground breaking surgery pioneered by Prof Jeff Rosenfeld in Melbourne, Australia and modified by Prof Hal Rekate in Phoenix, Arizona, patients with hypothalamic gliomas can be offered some hope with partial surgical resection of these tumours through a minimally invasive endoscopic operation. Given the location of the third ventricle, the open approach is very difficult and may cause many side-effects. These include, but are not confined to, seizures, paralysis, degrees of loss of memory, coma, and hormone imbalance. When done endoscopically, these complications may still occur but are less likely. The long-term results of surgery have yet to be published. This procedure is new and only time and honest reporting will tell if it is a permanent cure or only a temporary reprieve. The figures below are some examples of third ventricular tumours before and after surgery.... |
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| Small third vent tumour pre-op. This scan shows a small third ventricular tumour. Although the appearance is similar to a colloid cyst, pathology proved it was a ganglioglioma . |  |
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| Small third vent tumour post-op. This scan shows the tumour has been totally removed. It was done through an endoscopic approach and the patient was discharged from hospital 1 day after surgery in a perfect neurological state |  |
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| Large third vent tumour pre-op. This scan shows a tumour in the third ventricle of considerable size. It was called "inoperable" by previous surgeons. |  |
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| Large third vent tumour post-op. This scan shows the tumour was completely removed. Analysis of the tumour demonstrated a low grade astrocytoma. Although the tumour could not be removed through endoscopic techniques, the principles of minimally invasive surgery were applied and the patient still left the hospital 1 day after surgery in excellent condition and without complications. |  |
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| Last updated on Thursday 13th October, 2005. |