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Modern medicine, with significant developments in the diagnosis and therapeutic approach to brain tumors, has dramatically improved the course of many patients, both in terms of survival and quality of life. 

What are the most common brain tumors and how do they develop?

More than 2/3 of primary brain tumors, that is, tumors that do not originate from metastases of other tumors in the body, are benign. The prognosis for patients is particularly positive, as long as the tumor is treated with the assistance of a specialized neurosurgical team and the use of cutting-edge technology. A radical removal of the tumor means healing and the patient’s return to his daily life. Today, this is often achieved using an endoscope, through minimally invasive techniques (“keyhole incisions”). 

Even in cases of malignancy, the progress of neurosurgery in recent years has led to a significant increase in survival expectancy, while maintaining a good quality of life. 

The most common benign tumors are meningiomas, pituitary adenomas and acoustic neuromas. Gliomas in general and glioblastomas more specifically are the most common malignant tumors.  

Symptoms and diagnosis of brain tumors 

The growth of a brain tumor takes up space at the expense of healthy brain structures, surrounded by the rigid skull. As a result, larger tumors can cause increased intracranial pressure, leading to severe headaches, dizziness, decreased level of consciousness, and even coma. 

When the tumor presses on or infiltrates a specific function center or one of the bundles that connect these centers, then the corresponding dysfunction occurs, such as disorders in speech and/or comprehension, movement, or vision. Another common symptom is epilepsy, which occurs particularly frequently in cases of low-grade gliomas. 

The initial diagnosis is based on the patient’s medical history and neurological examination. The suspicion is significantly strengthened by imaging methods, mainly magnetic resonance imaging (MRI). However, the definitive diagnosis is confirmed by biopsy of the tumor. 

Surgical treatment of brain tumors

Meningiomas, pituitary adenomas and acoustic neurofibromas

Most meningiomas, pituitary adenomas, and acoustic neuromas do not require surgical removal. Small, asymptomatic tumors are initially monitored. Radiosurgery (such as cyberknife)is an additional option to reduce the chances of a tumor growing. However, when the tumor continues to grow and causes neurological symptoms, then the possibility of surgery should be seriously discussed. While biologically these tumors are characterized as benign, their surgical removal can be particularly dangerous, because most of the time these tumors enclose important structures, such as nerves and large vessels, injury to which can cause very serious permanent neurological damage.  

The use of the endoscopeLet us now offer the possibility to perform “keyhole approaches” and have excellent visualization of the surgical field and better surgical results.

The patient benefits after:

• recovers faster

• without appearance (when done transnasally) or with minimal incision 

• reduces the chances of possible complications, such as postoperative infections or bleeding

Malignant Gliomas / Glioblastomas 

Surgical removal of the tumor is almost always the first and decisive step in the treatment of malignant gliomas, as these are extremely aggressive tumors. The goal is to completely remove the tumor without affecting normal nerve function, which is now possible with the help of modern intraoperative techniques, such as surgery under: 

• fluorescent guidance, for accurate tumor localization

• neuromonitoringand brain mapping 

• interoperative neuronavigation with visualization of the bundles 

• with the patient awake, when the tumor is located near critical functional centers.

These are techniques for monitoring brain function as well as tumor boundaries. For example, during an operation with the patient awake, critical areas of the brain can be identified, which will be spared, so that the best safe resection can be performed.  

The degree of tumor resection is decisive for the subsequent course of the patient. Patients with both high-grade and low-grade gliomas in whom the tumor has been completely removed show a better prognosis than patients in whom it has been partially removed or who have undergone a simple biopsy.

Special brain tumor surgery centers

The radical and at the same time safe removal of a brain tumor is clearly more feasible in specialized neurosurgical centers. In such environments, the operations are performed by experienced neurosurgeons specializing in brain tumor surgery, who have been trained in leading international centers, have extensive surgical experience and actively participate in international scientific and interdisciplinary oncological collaborations. The expertise and expertise of these teams significantly increase the chances of an optimal therapeutic outcome with maximum preservation of neurological function.