Brain Tumors in Adults
Grade 1 and 2 -Astrocytoma and Pilocytic Astrocytoma
Grade 3 - Anaplastic Astrocytoma
Grade 4 - Glioblastoma multiforme
Metastatic Brain Tumors
Lung, Breast, Skin
Gliomas are tumors of the cells that support the neurons of the brain. The seriousness or prognosis of a glioma is typically related to the grade of the tumor. The grade is determined when a pathologist (a physician trained to examine and evaluate tissue samples) studies a specimen of the tumor that is obtained either via a surgical resection or biopsy. As such some form of surgical intervention is virtually always necessary to treat gliomas. Advanced technology such as frameless navigation systems pre-operative functional imaging (MEG and functional MRI) are available at UAB and are frequently employed to optimize the extent of tumor removal that can be performed safely. Many gliomas require additional therapy beyond surgery which may include radiation therapy and/or chemotherapy. Optimal care is obtained through a comprehensive Neuro-Oncology team which consists of experts from Oncology, Radiation Therapy and Neuosurgery. Only a limited number of medical centers in the nation have Neuro-Oncology programs that could rival those available at UAB.
A metastatic tumor occurs when there is a cancerous tumor elsewhere in the body which may spread to the brain via the blood stream. Surgery or Gamma Knife Treatment is usually recommended.
Skull Base Tumors
Acoustic Neuromas (Vestibular Schwannomas)
Meningiomas are tumors of the covering layers of the brain. As such they are often around the outside of the brain rather than deep within it. Surgical removal is often warranted but not in every single case. Factors such as the size and location of the tumor and the age and medical condition of the patient are important factors that your neurosurgeon will consider and review with you prior to making any surgical recommendation.
Acoustic neuromas are benign tumors of the vestibular nerve. The vestibular nerve and the nerves that allow hearing and move the facial muscles all run together. A variety of treatments exist for acoustic neuromas including open microsurgery or Gamma Knife stereotactic radiosurgery.
The pituitary gland has a central role coordinating the relationship between the brain and the hormones of the body. As such some pituitary tumors may become symptomatic because of hormone abnormalities. This depends on which hormone is over secreted. Prolactin secreting tumors (Prolactinomas) may cause impotence in males and breast discharge in females. ACTH secreting tumors cause Cushing's Disease which can result in high blood pressure, abdominal fat collections, thinning of the hair and red streaks on the skin. Growth hormone secreting tumors cause acromegaly which is manifest as enlargement and coarsening of the hands, feet and facial features. Most pituitary tumors are not actively secreting hormones and as such are called non-secretory tumors. These tumors may cause symptoms by growing and causing headache or compressing nearby structures. Nerves important in vision pass immediately above the pituitary region and as such visual impairment can be a sign of a pituitary tumor. Rarely tumors can undergo spontaneous bleeding within them and expand rapidly causing severe headache and visual loss. This is called pituitary apoplexy and it represents an urgent need for surgery.
Pituitary tumors often require surgical intervention but surgery may often can be performed utilizing minimally invasive techniques such as trans-nasal endoscopy. Dr. Kristen Riley directs the pituitary disorders clinic in conjunction with colleagues in ENT, Endocrinology, Opthalmology and Radiation Therapy to provide excellent comprehensive care.