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Diagnosis in Brain Tumors

Most Common Complaints and Symptoms That are Encountered in Patients:
  • Headache (the most frequent complaint)

  • Nausea and vomiting, balance disorder

  • Seizures (local or involving the whole body)

  • Speech, visual and hearing disorders

  • Strength loss in hands and/or feet

  • Paralysis in different types and loss of feel and sense

  • Urinary and fecal incontinence etc.

Diagnosis

When patients consult to doctors with such complaints the following are usually performed to diagnose the patients after consultation if they are suspected of having a brain tumor:

Neurologic Examination

First, mental functions, coordination, and speech are tested. Then, cranial nerve functions such as vision, hearing, face-tongue movements are examined. Strength (motor) and sensory examinations are performed next. Then it may be necessary to examine the reflexes, balance and other functions. Difficulty in one or more areas may provide insight as to the part of your brain that may be affected by a brain tumor.

Imaging Methods

Magnetic Resonance Imaging (MRI) is usually the desired examination for suspected brain tumors. MRI is often diagnostic. In some patients, intravenous contrast injection may be required during imaging (contrast-enhanced MRI). The aim here is to allow the drug to be more easily distinguishable from normal brain tissue as a result of the increased intake of the drug by the tumor tissue. This will work in tumors which have an MR image that is similar to the normal brain tissue. With MR spectroscopy, types of tumors can be estimated by looking inside the density of a molecule in the tumor. Functional MRI examines the location of specific centers such as the speech center and centers that move the body (motor centers) and their relation to the tumor. Specific MRI methods such as tractography, perfusion MRI, diffusion MRI may also be necessary for the treatment plan, as they may prove useful in diagnosing the patient. Sometimes, additional examinations such as brain tomography may be necessary together with MRI. Tomography shows calcification in the tumor. Brain tomography can be used for diagnostic purposes as well as for surgery planning in tumors associated with the skull, as it is better in showing bone structures in detail.

Examinations Necessary for Cancer Diagnosis in Other Parts of the Body

If your brain tumor is suspected of spreading (metastasis) from another part of the body, then additional tests such as PET-BT, scintigraphy and whole-body MRI may be required to detect those tumors.

Biopsy

The sampling and testing of abnormal tissue in the brain. It can be performed with a thin needle through an open or small hole like brain surgery. A stereotactic needle biopsy can be performed for very sensitive areas that can be damaged by a more comprehensive operation in the brain or for brain tumors that are located in hard-to-reach areas. In this procedure, after a small hole has been drilled in the skull, coordinates are plotted according to the point determined as a result of MRI and BT, and a tissue sample is taken from this point for pathology. These tissue samples are examined under a microscope in pathology laboratories and they provide information on the tumor type, whether it is benign or malignant, the treatments required and the prognosis.

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