The great artist Mustafa Fahmy passed away as a result of complications resulting from a delicate brain surgery. These operations require a high level of caution and experience, however, some negative effects may appear in some patients after surgery, and these effects vary in severity and impact depending on each patient's condition. In the following report,Dalili Medical reviews a group of complications of brain tumors, as the brain, like the rest of the body, can be affected by benign and malignant tumors. There is no doubt that a vital organ such as the brain is affected by a tumor, which raises concern for the patient and his family. What are the causes of brain tumors, and what are the silent signs that may indicate the presence of a brain tumor? What are the symptoms associated with them?

What is a brain tumor?

 

A brain tumor is an abnormal collection of cells within the brain. Brain tumors can be classified into two types: benign and malignant. Malignant tumors are considered cancerous, while benign tumors may be less dangerous in other parts of the body, but are considered more dangerous when they are present in the brain. Benign brain tumors can lead to disability or even death, because the brain is in a closed cavity within the skull, causing excess tissue to cause pressure that negatively affects brain function.

Risk factors for brain tumors?

 

. **Family history**: 5-10% of all cancers are inherited. Individuals with a family history of a brain tumor are advised to see a doctor for genetic counseling.

. **Age**: The risk of developing brain tumors increases with age.

. **Race**: Brain tumors are more common among Caucasians than Africans.

. **Exposure to chemicals**: Exposure to certain chemicals may increase the risk.

. **Radiation exposure**: Exposure to radiation is one of the factors that may contribute to an increased risk of developing brain tumors.

**What are the types of benign brain tumors?**

 

Benign brain tumors arise from the brain cells themselves, or from blood vessel or nerve cells within the brain. The most common types include:

. **Meningioma**: This tumor is formed from the cells of the membranes that surround the brain and spinal cord, and it represents about 20% of benign brain tumors.

. **Acoustic neuroma**: This tumor arises from the cells of the insulating layer of nerve cells (Schwann cells), and affects the eighth nerve, and represents about 9% of benign brain tumors.

. **Pituitary tumor**: This tumor forms in the pituitary gland located inside the brain, and represents about 8% of benign brain tumors.

. **Hemangioblastoma**: This tumor appears in the blood vessels of the brain, and represents about 2% of benign brain tumors.

. **Cranial (cranial) pharyngeal tumor**: This tumor affects children mainly, and represents between 1% and 3% of benign brain tumors.

. **Choroid plexus papilloma**: This tumor also appears noticeably in children, and appears as a mass of cells that affect the flow of cerebrospinal fluid, and represents less than 1% of benign brain tumors.

. **Glioma**: This type of tumor affects the glial cells in the brain.

**Second: Malignant brain tumors**

There are more than 120 types of brain cancer, which makes their classification complex. However, brain cancer tumors can be divided into two main types:

. **Primary tumors**: These tumors arise as a result of a defect in brain cells, as these cells begin to divide in an unregulated manner, leading to the appearance of the tumor.

. **Secondary tumors**: Refers to tumors that form in the brain as a result of the spread of cancer cells from another affected organ, such as the lung or kidney.

Brain tumors are also classified according to their severity into four stages:

- **Stage I**: Tumors at this stage are characterized by slow growth and lack of tendency to spread, and often respond well to surgical treatment.

- **Stage II**: Includes tumors that also do not tend to grow and spread, but may return after removal.

- **Stage III**: Tumors of this stage are characterized by rapid growth and the ability to invade nearby tissues, and may return more severely after a period of treatment.

- **Stage IV**: This is considered the most dangerous stage, as tumors are characterized by rapid growth and division, and their ability to easily invade nearby tissues, in addition to exploiting blood vessels to nourish them and continue their growth.

Do the symptoms of a brain tumor differ according to its type?

Yes, the symptoms may differ, and it has been noted that each tumor site has its own symptoms. It is important to know that brain tumors are divided into two main types:

. **Benign brain tumor** A benign brain tumor is characterized by not containing cancer cells, as this type of tumor grows slowly and can be surgically removed. These tumors rarely spread to the tissues surrounding the brain. However, a benign brain tumor may cause problems in the brain due to constant pressure, and may be life-threatening depending on its location.

. **Malignant Brain Tumor** Malignant brain tumors contain cancer cells, and their growth rates vary. These cells can invade healthy tissue surrounding the brain. Malignant tumors rarely spread outside the brain or spinal cord.

Symptoms of brain cancer in women:

Many people search for early symptoms of brain tumors in women in particular, but medical studies and research have shown that there are no symptoms specific to brain cancer in women only, as brain tumors are not a disease limited to women without men. General symptoms of brain tumors include:

- Severe headache, often in the morning.

- A constant feeling of nausea and vomiting.

- Seizures.

- A constant desire to sleep.

- Poor concentration and memory.

- Behavioral changes such as confusion and anxiety.

- Loss of balance while walking.

- Impact on the senses of hearing and smell.

- Vision problems, such as seeing things double.

- Pulse disturbances.

- Abnormal breathing.

- Noticeable changes inBlood pressure, which occurs in the advanced stages of the disease.

**Symptoms of a tumor in the back of the head:**

 

The symptoms of a brain tumor are similar to the symptoms of many other diseases, such as recurrent headaches, vomiting, and loss of balance. However, if these symptoms recur on a daily basis, it becomes necessary to consult a doctor and conduct examinations and x-rays to determine the real cause behind these symptoms. The patient may feel very tired in the back of the head, but it cannot be confirmed that there is a benign or malignant brain tumor until after conducting the necessary examinations that confirm or deny the presence of a tumor.

Among the silent symptoms of a brain tumor are:

- Chronic headache that increases in severity upon waking up from sleep and does not respond to painkillers.

- The patient may not notice his vision weakening directly, but he realizes it when he collides with the surrounding objects.

- The presence of a tumor affects the signals sent by the brain to the body's organs, leading to the appearance of a deficiency in the body's functions.

- The sudden appearance of stuttering in speech is an indication of the presence of a brain tumor.

- Persistent vomiting in the morning may be associated with a brain tumor.

**Silent brain tumor symptoms**

 

The symptoms of a silent brain tumor are many and varied, and in this article we will review the most prominent of these symptoms:

. **Chronic headache**It is difficult to distinguish between a headache resulting from a brain tumor and a regular headache that many people suffer from. Even doctors may find it difficult to determine the cause of this headache. However, there are some signs that may indicate that the headache is caused by a brain tumor, such as being persistent and getting worse when waking up from sleep, in addition to the pain worsening over time and not responding to available treatments.

Symptoms vary from person to person based on the growth rate, size, and stage of the tumor. For example, a small, rapidly growing tumor may cause a severe headache.

**. Blurred vision**At first, the patient may not realize that he or she is suffering from poor vision, but this weakness can be detected in different situations, such as repeatedly bumping into surrounding objects. This problem gets worse over time, and if the patient notices that he is facing increasing difficulties in vision, he should undergo brain examinations after consulting a doctor to detect any problems early.

**. Fatigue and lethargy **When there is a brain tumor, it affects the signals sent by the brain to various parts of the body, leading to dysfunction and disturbances in the body's functions. As a result, the organs may not respond properly to these signals, causing a feeling of laziness, lethargy, and a desire to rest most of the time.

It is not limited to feeling lethargic only, but it may develop into dizziness and loss of balance, as the tumor affects the area responsible for maintaining balance.

. Difficulty speaking **If you notice a sudden stuttering or stammering in speech, this may be evidence of the presence of a tumor, as this tumor can hinder the functions of the speech centers in the brain, leading to difficulty speaking normally. This problem is considered one of the prominent symptoms that may indicate the presence of a brain tumor.

. Mood swings and tendency to violence**A brain tumor can put pressure on parts of the frontal lobe, which is responsible for personality traits, leading to changes in behavior and mood swings, in addition to an increased tendency to anger and nervousness. These symptoms may be accompanied by sleep disturbances, and may even lead to depression without a clear cause, which hides this serious disease.

. Hearing problems**If you suffer from hearing problems, such as hearing loss or annoying ringing in the ear, it is necessary to see a doctor. These problems may be caused by pressure on the temporal lobe of the brain, which is responsible for hearing, which may occur as a result of a brain tumor.

. Impaired fertility**The pituitary gland produces hormones responsible for fertility, and when a brain tumor affects the pituitary gland, it hinders its normal function. This leads to problems in the production of these hormones, resulting in impairing fertility that may develop into infertility.

Therefore, individuals with a brain tumor may face sexual problems that negatively affect the chances of pregnancy and childbirth, whether in men or women.

. Nausea and vomiting** There is a close link between morning sickness, which may sometimes reach the point of vomiting, and a brain tumor, as it is accompanied by other symptoms such as: headaches and loss of balance. It is necessary to consult a doctor if nausea continues daily and repeatedly without a clear cause.

Symptoms of brain tumors according to the location of the tumor:

**Frontal lobe** The frontal lobe is responsible for controlling movement, behavior, and personality. Symptoms of a tumor in this area may include the following:

- Effects on the senses, such as problems with vision or speech, or loss of the sense of smell.

- Weakness on one side of the face or on one side of the body.

- Changes in behavior and personality.

- Mood swings and depression.

- Difficulty thinking and planning.

**Temporal lobe** The temporal lobe is important in the processes of hearing, understanding sounds, and forming memory. Symptoms associated with a brain tumor in this lobe include:

- Poor short-term memory and difficulty learning.

- Difficulty hearing and speaking.

- Feeling strange experiences or feeling that a certain event is recurring from time to time (déjà vu).

**Parietal lobe**The parietal lobe is responsible for recognizing objects and determining their locations and positions. Symptoms of a tumor in this part may include the following:

- Problems reading or writing.

- Difficulty speaking and understanding.

- Loss of the ability to perceive the positions of objects in relation to each other.

- Loss of sensation in a part of the body.

**Occipital lobe**The occipital lobe is responsible for vision, so symptoms of a brain tumor in this part may include the following:

- Changes in vision or loss of part of it.

- Difficulty recognizing familiar objects.

- Inability to distinguish faces.

- Loss of vision.

**Meningitis**The main symptoms of meningiomas include the following:

- Vomiting.

- Headaches.

- Weakness in the arm orLeg.

- Confusion.

- Personality changes.

**Cerebellum** The cerebellum is an essential part of maintaining the body's balance and coordination of movements. Tumors in this area may lead to:

- Feeling dizzy.

- Problems with motor coordination and balance, and difficulty walking.

- Involuntary eye movements.

- Difficulty speaking and interrupted speech.

**Brain stem** The brain stem is the center for controlling the body's vital functions, and tumors affecting this area may lead to the following symptoms:

- Difficulty swallowing and speaking.

- Vomiting.

- Weakness or numbness in part of the face, or weakness in the arm or leg.

- Hearing loss on one side.

- Vision problems.

- Difficulty walking and loss of balance.

- Sleep cycle disturbances.

**Pituitary gland** The pituitary gland produces a group of essential hormones for the human body, and symptoms of a tumor in this gland may appear in the form of:

- Weight gain.

- Vision problems.

- Persistent headaches.

- Mood swings.

- Sexual problems, such as erectile dysfunction and decreased libido.

- Breast milk secretion.

**Glioma:** This type of tumor is known as a glioma, and it affects brain function. Symptoms associated with it include:

- Frequent headaches.

- Vomiting and nausea.

- Urinary incontinence.

- Memory loss.

- Deterioration in general condition.

- Poor vision and difficulty speaking.

**Complications of brain surgery**

**Brain hemorrhage** Some patients may suffer from internal bleeding after surgery, as a result of damage to blood vessels during the operation. This bleeding can lead to very serious conditions.

**Infection** Like any other surgery, brain surgery carries the risk of infection at the wound site, which can cause encephalitis.

**Brain swelling** Swelling of the brain tissue may occur after surgery, increasing pressure inside the skull and making the condition more serious.

**Blood clots** Blood clots can form around the brain, blocking blood flow and leading to a risk of stroke.

**Nerve tissue damage** Brain surgery can damage nerve tissue, affecting vital functions such as movement, speech, and memory.

**Neurological complications** Neurological complications from brain surgery include seizures, weakness in the limbs, changes in mood or personality, and difficulties with balance.

**Immediate side effects after surgery**

 

Side effects that may occur after surgery include:

- Difficulty speaking.

- Swelling in the brain.

- Delirium and confusion.

- Problems with movement or balance.

- Dizziness.

- Headache.

**Long-term risks after surgery**

Long-term risks that may occur include:

- Changes in behavior.

- Memory loss.

- Problems with speech.

- Difficulty walking.

- Weakness in the arms or legs.

- Brain damage.

**Complications of brain tumor removal surgery in children**

Symptoms of complications that may appear in children include:

- Fever (temperature of 37.8 degrees Celsius under the armpit, or 38.5 degrees Celsius in the mouth).

- Redness at the incision site.

- Leakage of fluid from the surgical incision.

- Headache.

- Vomiting.

Problems swallowing and difficulty speaking after surgery are usually temporary.

Warning! You should contact the treatment team and the specialist doctor immediately if you notice any of these symptoms in your child.

Complications of brain tumor removal surgery in children are divided into two categories:

1. Unexpected complications: require immediate attention from the treatment team.

2. Expected complications: associated with certain types of surgery, such as neurological deficits, hormonal problems, difficulty speaking, or swallowing problems.

**Brain Tumor Diagnostic Tests:**

 

- A comprehensive physical and neurological examination is performed to assess vision, hearing, muscle reflexes, coordination of movement and sensation, as well as other neurological functions.

- Magnetic Resonance Imaging (MRI).

- Examination of the cerebrospinal fluid (CSF).

**Biopsy:** A sample of tissue is collected using a needle inserted into the skull through a small hole, to be tested for information about the brain tumor.

**Imaging Tests:** Doctors recommend various imaging tests to determine the location and type of brain tumor. These tests include MRI, CT scan, and PET (positron emission tomography), and are performed to ensure an accurate diagnosis of brain tumors.

**Cerebral Angiography** Cerebral angiography is used to determine the location and type of brain tumor. A colored dye is injected into the arteries of the patient's head, and then images are taken to document the condition.

**Spinal Tap** A spinal tap or lumbar puncture is performed to extract cerebrospinal fluid from the patient using a fine needle, to search for the presence of cancer cells.

**Myelogram** The doctor may also suggest a myelogram to check if cancer cells have spread to the spinal fluid.

**Vision, hearing and neurological tests** These tests are performed to assess brain performance and examine the effect of the tumor on brain function.

**Treatment of benign brain tumors**

 

When benign brain tumors are discovered, doctors develop an appropriate treatment plan that is proportional to the size and location of the tumor. Treatment is often done through surgery, but in some cases, other methods and techniques may be required.

The goal of removing these tumors is to reduce their spread or transformation into malignant cancerous tumors. When developing the appropriate treatment plan, periodic examinations are performed to monitor the tumor and assess its growth, both before starting treatment and during the treatment period.

**First: Surgical treatment** Surgical treatment is the primary option for treating non-cancerous brain tumors, as it aims to safely remove as much of the tumor as possible, while taking care to protect the healthy tissue surrounding the tumor. Most of these operations are performed under general anesthesia, which means that the patient will be unconscious during the procedure. However, in someIn some cases, it may be necessary to perform the procedure under local anesthesia, allowing the patient to interact and evaluate the progress of the procedure.

Before starting the procedure, the scalp area is shaved, then the skull is opened to access the brain and tumor. After the tumor is removed, the bones are re-cut and fixed with metal screws, then the skin is closed with sutures or staples.

In cases where the tumor cannot be completely removed through surgery, the patient may need to receive additional treatments such as chemotherapy or radiation therapy.

**Second: Radiotherapy** Radiotherapy relies on the use of a special type of radiation to remove the benign tumor in the brain. Small beams of high-energy radiation, such as X-rays, are directed towards the tumor with the aim of destroying abnormal cells.

In most cases, the patient only needs one session of radiotherapy, and this treatment is characterized by speed, as the patient can leave the medical center immediately after the session is over.

**Third: Chemotherapy** Doses of specific drugs are used to remove the remaining parts of the benign tumor in the brain. However, this type of treatment is considered less common in cases of benign tumors. If given to the patient, it may be in the form of injections or tablets.

Many side effects appear after receiving this treatment, the most prominent of which are feeling tired, hair loss from the body and head, nausea, and skin redness.

**Success rate of benign brain tumor removal**

 

Benign brain tumor removal is considered a medical procedure with high success rates. Most patients who follow the prescribed treatment plan live for long periods after the end of treatment. Most of these cases do not suffer from the recurrence of the tumor again. However, there are no accurate studies that determine the success rates of the operation specifically.

**Duration of brain tumor removal**The time doctors need to remove a brain tumor varies depending on the location and size of the tumor, in addition to the patient's condition. Therefore, a specific time period cannot be determined in advance. It is often difficult for doctors to estimate the time required for the operation before starting it, as the conditions that occur during the operation and the factors mentioned above play an important role in this.

In general, most patients stay in the hospital for three days after the surgery. As for radiation or chemotherapy, the number of sessions required is determined later if necessary. Usually, patients do not need to stay in the hospital after chemotherapy or radiation sessions.