DATE The Role of the Brain in the Central Nervous System The central nervous system consists of the brain and spinal cord The brain is the vital organ in the body that controls thought, memory, emotio.
Trang 1The Role of the Brain in the Central Nervous System
The central nervous system consists of the brain and spinal cord The brain is the vital organ in the body that controls thought, memory, emotion, touch, motor skills, vision, respirations, temperature, hunger, and every process that regulates our body
Each part of the brain has a role in controlling the body The brain controls breathing, blood flow, and movement The brain also allows you to think, handle emotions, and make judgments
A high-level map of brain function The Different Parts of the Brain
The front of the brain is the center for emotions and reasoning This is where
personality comes from
The right side of the brain controls the left side of the body The right side also
directs problem-solving and spatial skills, such as judging distance
The left side of the brain controls the right side of the body It also handles verbal
or language skills
The brainstem handles basic body functions, such as breathing, blood flow, and
swallowing
The back of the brain controls vision
Trang 2A high-level map of brain anatomy
At a high level, the brain can be divided into the cerebrum, brainstem, and cerebellum:
Cerebrum
The cerebrum (located in the front of the brain) is composed of the right and left hemispheres Functions of the cerebrum include: initiation of movement,
coordination of movement, temperature, touch, vision, hearing, judgment,
reasoning, problem solving, emotions, and learning
Brainstem
The brainstem (located in the middle of the brain) includes the midbrain, the pons, and the medulla Functions of this area include: movement of the eyes and mouth, relaying sensory messages (hot, pain, loud, etc.), hunger, respiration, consciousness, cardiac function, body temperature, involuntary muscle movement, sneezing, coughing, vomiting and swallowing
Cerebellum
The cerebellum is at the back of the brain Its function is to coordinate voluntary muscle movements and to maintain posture, balance, and equilibrium
A More Detailed Look at the Brain
A More Detailed Map of Brain Anatomy
Depending on the location of your tumor, you may want to discuss some parts of the brain
in greater detail with your medical team at the Stanford Brain Tumor Center This section, which defines the function of more specific areas of the brain, can help you do that
Trang 3 Pons
The pons contains many of the control areas for facial movements It is located in a deep part of the brain in the brainstem
Medulla
The medulla is the most vital part of the brain and contains important control centers for the heart and lungs It is located in the lowest part of the brainstem
Spinal cord
The spinal cord is a large bundle of nerve fibers that carries messages to and from the brain and the rest of the body It is located in the spine and extends from the base of the brain to the lower back
Frontal lobe
The frontal lobe is involved in personality characteristics and movement In
addition, recognition of smell usually involves parts of the frontal lobe The frontal lobe is the largest section of the brain, located in the front of the head
Parietal lobe
The parietal lobe helps a person to identify objects and understand spatial
relationships (where one's body is compared to objects around the person) The parietal lobe is also involved in interpreting pain and touch in the body It is located
in the middle part of the brain
Occipital lobe
The occipital lobe is located in the back part of the brain that is involved with vision
Temporal lobe
The temporal lobes are involved in memory, speech, musical rhythm, and some degree of smell recognition They are located on the sides of the brain
What Is A Brain Tumor?
Trang 4Brain anatomy illustrating tumor and tumor cells
A brain tumor is an abnormal growth of tissue in the brain The tumor can either originate
in the brain itself (primary brain tumor), or come from another part of the body and travel
to the brain (metastatic or secondary tumor) Brain tumors are classified as either benign (non-cancerous) or malignant (cancerous), depending on their location, size and behavior
A benign tumor does not contain cancer cells and once it is removed it usually does not
recur Most benign brain tumors have clear borders, meaning they do not invade the
surrounding tissue These tumors can however cause symptoms similar to cancerous tumors depending on size and location
Malignant brain tumors do contain cancer cells They are usually fast growing and
invade surrounding tissue Malignant brain tumors very rarely spread to other areas of the body, but may recur within the brain even after treatment Sometimes brain tumors that are not cancerous are called malignant because of their size and location and the damage they can therefore do to vital functions of the brain
Metastatic brain tumors are tumors that begin to grow in another part of the body and
then spread to the brain through the lymph nodes and bloodstream Common types of cancer that can travel to the brain include lung cancer, breast cancer, nasopharyngeal cancer, melanoma (a type of skin cancer), and colon cancer Metastatic cancers are
described and treated based on the specific type of the original cancer For example, breast cancer that has spread to the brain is called metastatic breast cancer
How Common Is Brain Cancer?
Brain Cancer is a brain tumor that has been diagnosed as being malignant
The American Cancer Society's estimates for malignant brain and spinal cord tumors in the
Trang 5United States for 2011 are cited here They include both adults and children These
statistics are only for tumors that begin in the brain If they included tumors that migrated
to the brain (metastatic tumors, the numbers would be much higher)
About 22,340 malignant tumors of the brain or spinal cord (12,260 in males and 10,080 in females) will be diagnosed in 2011 Overall, the chance that a person will develop a
malignant tumor of the brain or spinal cord in his or her lifetime is less than 1% (about 1 in
150 for a man and 1 in 185 for a woman)
Survival rates for malignant brain tumors vary widely The rates depend on the type of tumor and many other factors, including where the patient is treated and how experienced the physicians are who are responsible for treating the patient with neurosurgery, radiation
or chemotherapy That is why it is important to be seen at the Stanford Brain Tumor Center What Causes Brain Tumors?
Patients often want to know if brain tumors are hereditary They are not Some hereditary diseases are linked to brain tumors, but these are very rare diseases
Brain and spinal tumors are masses of cells that have grown out of control This
uncontrolled growth results from changes directly in the tumor cell’s genes Researchers at Stanford are working hard to figure out what causes these changes in the cell’s DNA (genetic material) It is know that some causes are environmental while others are genetic Most primary brain tumors are not associated with any known risk factors and have no obvious cause, but there are a few factors, both genetic and environmental, that may raise the risk of brain tumors Many researchers at Stanford are studying the cause of primary brain tumors so that they can develop novel and improved methods of treating brain cancer
People who work in oil refining, rubber manufacturing, and with chemicals may have a higher incidence of certain types of tumors Which chemical toxins may be related to an increase in tumors not known at this time
Patients who have received radiation therapy to the head as part of prior treatment for other malignancies are also at an increased risk for new brain tumors
What Are the Symptoms of a Brain Tumor?
The following are the most common symptoms of a brain tumor However, each person will experience symptoms differently Symptoms vary depending on the size and location
of the tumor Many symptoms are related to an increase in pressure in or around the brain This is known as intracranial pressure or ICP There is no spare space in the skull for anything except the delicate tissues of the brain and its fluid Any tumor, extra tissue, or fluid can cause pressure on the brain and result in increased intracranial pressure
Increased intracranial pressure can cause the following symptoms:
Headache
Trang 6 Vomiting (usually in the morning)
Nausea
Personality changes
Irritability
Drowsiness
Depression
Decreased cardiac and respiratory function and eventually coma, if not treated Symptoms of brain tumors in the cerebrum (front of brain) may include:
Increased intracranial pressure
Seizures
Visual changes
Slurred speech
Paralysis or weakness on half of the body or face
Drowsiness and/or confusion
Personality changes/impaired judgment
Short-term memory loss
Problems with walking
Communication problems
Symptoms of brain tumors in the brainstem (base of the brain) may include:
Increased intracranial pressure
Seizures
Endocrine problems (diabetes and/or hormone regulation)
Visual changes or double vision
Headaches
Trang 7 Paralysis of nerves/muscles of the face or in one half of the body
Respiratory changes
Clumsy, uncoordinated walk
Hearing loss
Personality changes
Symptoms of brain tumors in the cerebellum (back of brain) may include:
Increased intracranial pressure
Vomiting (usually occurs in the morning without nausea)
Headache
Uncoordinated muscle movements
Problems with walking
What are the Different Types of Brain Tumors?
There are many different types of brain tumors that originate in the brain They are categorized by the type of cell where the tumor begins, or by the area of the brain where they occur Some tumors begin outside the brain and spread to the brain Others begin locally in the brain At the Stanford Brain Tumor Clinic, we have a lot of experience treating both the common tumors and those that are less common
Metastatic tumors – Tumors that spread to the brain
In adults, metastatic brain tumors are the most common type of brain tumors These are tumors that begin in another part of the body, and spread to the brain through the
bloodstream Lung, breast, and colon cancers frequently travel to the brain, as do certain
Trang 8skin cancers Metastatic brain tumors may be quite aggressive and may return after surgery, radiation therapy, and chemotherapy
Common tumors that originate in the brain
Glioma
The most common type of primary brain tumor is a glioma Gliomas begin from glial cells, which are the supportive tissue of the brain There are several types of gliomas, categorized
by where they are found, and the type of cells that originated the tumor
Astrocytoma
Astrocytomas are the most common type of primary brain tumor in adults Astrocytomas are further classified by their symptoms, treatment, and prognosis, along with the location
of the tumor In adults, astrocytomas are more common in the cerebral hemispheres
(cerebrum), where they commonly cause increased intracranial pressure (ICP), seizures, or changes in behavior
Glioblastoma
High-grade astrocytomas are called glioblastomas Glioblastomas are the most malignant of all brain tumors We routinely treat glioblastomas at the Stanford Brain Tumor Center with
a broad range of treatments that can help to delay the tumor’s impact and growth
Meningiomas
Meningiomas are usually benign tumors that come from the meninges or dura, which is the tough outer covering of the brain just under the skull This type of tumor accounts for about one third of brain tumors in adults They are slow growing and may exist for years before being detected Meningiomas are most common in older patients, with the highest rate occurring in people in their 70s and 80s The tumors can sometimes be removed entirely during surgery
Schwannomas and Neuromas
Schwannomas are benign tumors They are most common on the nerves that control
hearing and balance When schwannomas involve these nerves, they are called vestibular schwannomas or acoustic neuromas Symptoms of these tumors often include problems with hearing or with weakness on one side of the face Surgery can be difficult because of the area of the brain in which they occur, and the vital structures around the tumor
Occasionally, radiation (or a combination of surgery and radiation) is used to treat these tumors
Trang 9Pituitary Tumors
The pituitary gland is located at the base of the brain It produces hormones that control many other glands in the body Pituitary tumors can lead to problems with thyroid
functioning, impotence, milk production from the breasts, irregular menstrual periods, or problems regulating the fluid balance in the body Due to the closeness of the pituitary gland to the nerves of the eyes, patients with these tumors may have decreased vision Tumors in the pituitary are frequently benign Since the pituitary is at the base of the skull, removal of a pituitary tumor at Stanford is often done using an advanced technique where the physicians can access the tumor through the nose without external surgery Some pituitary tumors can be treated with medication, to shrink the tumor or stop the growth of the tumor without surgery
Primitive neuroectodermal tumors (PNET)
PNET tumors can occur anywhere in the brain, although the most common place is in the back of the brain near the cerebellum where they are called medulloblastomas The
symptoms depend on the location in the brain, but usually the patient experiences increased intracranial pressure These tumors are fast growing and often malignant, occasional spreading throughout the brain or spinal cord
Spinal Tumors
Spinal tumors are primary or metastatic lesions that can involve both the spinal cord and the vertebrae comprising the bony spinal column Compression of the spinal cord or
collapse of the spinal column may result in paralysis, loss of bowel and bladder function, pain, and loss of functional capacity The cornerstone of treatment for metastatic spinal lesions has been palliation of pain and preservation of neurological function Conversely, the central tenet of treating primary tumors of the spine, such as chondrosarcomas,
sarcomas, and chordomas, along with select oligometastatic lesions, is complete margin-free en bloc resection
Total en bloc spondylectomy (TES) is a surgical technique aimed at achieving en bloc resection of these types of spinal tumors The TES procedure has one primary goal: to completely and safely remove a spinal tumor and minimize the risk of recurrence TES continues to offer promise as a salvage strategy for patients failing treatment with radiation
or radiosurgery TES is recognized as a very technically challenging surgical procedure that
is available at only a few medical centers in the world, including Stanford Hospital & Clinics