Principal Director & HOD, Neuro and Spine Surgery, Fortis Hospital, Shalimar Bagh, New Delhi
Series overview · 9 articles
Brain Tumour
June 9, 2024
A brain tumour diagnosis raises immediate questions about whether it is cancerous, how it should be treated, and what outcomes to expect. Dr. Sonal Gupta, Principal Director & HOD, Neuro and Spine Surgery at Fortis Hospital, Shalimar Bagh, New Delhi, used her Jivo Masterclass to walk through how brain tumours are classified, the symptoms and headache characteristics that point towards a diagnosis, how imaging is used to distinguish benign from malignant disease, the surgical and non-surgical treatment options available today, and how paediatric brain tumours and epilepsy surgery are approached.
What this series covers
This series works through how brain tumours are classified by origin and behaviour, the symptoms and specific headache characteristics that should prompt imaging, the diagnostic tests used to tell a benign tumour from a malignant one, the surgical technologies (neuronavigation-guided keyhole surgery, radiosurgery) that have changed outcomes, the realistic complication rates of modern surgery, when epilepsy surgery is appropriate, how childhood and even newborn brain tumours are identified and managed, and a real patient case that illustrates the decision-making involved.
This article is based on a Jivo Masterclass session conducted by Dr. Sonal Gupta, Principal Director & HOD, Neuro and Spine Surgery, Fortis Hospital, Shalimar Bagh, New Delhi. The article has been summarised with the assistance of an AI tool from the original masterclass recording. Watch the full Masterclass recording
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This guide is based on a live Jivo Masterclass: Dr. Sonal Gupta taught doctors across Africa on June 9, 2024.
FROM THE LIVE Q&A
Dr. Michelle
For a 17-year-old patient showing several of these symptoms, what characteristics should guide a referral for further workup?
Dr. Sonal Gupta
Symptoms alone do not distinguish a benign tumour from a malignant one; both can present the same way. A CT scan and MRI together can predict whether a tumour is benign or malignant with about 90% accuracy, though only a biopsy can confirm the diagnosis and grade. Any patient with these symptoms should be sent for an MRI.
Frequently Asked Questions
How can epilepsy surgery be made practical and accessible for African patients?▼
Not every epilepsy patient needs surgery - only intractable epilepsy (uncontrolled despite adequate medication) or epilepsy caused by a visible lesion on MRI warrants it. To make this accessible, an online epilepsy clinic can review a patient's medication history and MRI findings remotely, and only call the patient to India for a surgical workup once epilepsy is confirmed to be intractable.
If an adult has a first-time seizure, is it correct to suspect a brain tumour as the cause?▼
Every patient presenting with a seizure should have an MRI under the epilepsy protocol with contrast, since a CT scan can miss small lesions responsible for epilepsy. However, not all seizure disorders are caused by a brain tumour.
How are childhood brain tumours identified and managed differently from adult ones?▼
Identification is the same as in adults. The surgical approach is also the same, but radiotherapy and chemotherapy protocols must be modified according to the child's age.
Can a brain tumour be detected in a newborn?▼
Yes. An ultrasound of the skull can be used as a screening test to check for excess fluid or a tumour, but an MRI is required for a definitive diagnosis even in a newborn.
What are the post-operative complications of brain tumour surgery?▼
Complications have come down to under 5% of cases. They include epilepsy, a haematoma (clot) at the surgical site, infection from open surgery, and, if the tumour is very large, the possibility that a portion has to be left behind.
What does this masterclass series cover?▼
Brain tumour classification, symptoms and headache red flags, diagnostic imaging, surgical and radiosurgery treatment options, complication rates, epilepsy surgery, paediatric brain tumours, and a real patient case.
Who is Dr. Sonal Gupta?▼
Principal Director & HOD, Neuro and Spine Surgery at Fortis Hospital, Shalimar Bagh, New Delhi.
In This Series: Diagnosis and Management of Brain Tumour
- 1.Brain Tumour
- 2.How Brain Tumours Are Classified: Benign, Malignant, Primary and Secondary
- 3.Brain Tumour Symptoms and Which Headaches Are Red Flags
- 4.Diagnosing Brain Tumours: CT, MRI and Beyond
- 5.Brain Tumour Surgery and Radiosurgery: Treatment Options Explained
- 6.Brain Tumour Surgery: Realistic Complication Rates and Recovery
- 7.Epilepsy Surgery: Who Needs It and How It Helps
- 8.Brain Tumours in Children and Newborns: Diagnosis and Management
- 9.Real Brain Tumour Cases: Weighing Surgery Against Radiosurgery