Brain Tumor Surgery in Iran

Table of Contents

Treatment of medulloblastoma, a malignant brain tumor of the cerebellum with open and minimally invasive surgery

Medulloblastoma is a type of brain tumor.
Brain tumors occur when healthy brain cells change, grow out of control, and form a mass.
The tumor can be cancerous or benign.
A cancerous tumor is malignant, meaning it can grow and spread to other parts of the body.
A benign tumor is a tumor that does not spread.
The brain and spinal cord make up the central nervous system (CNS), which controls all vital functions, such as thinking, speech, and body power. Meduloblastoma has the highest prevalence in children.

What factors affect the success of treatment?

The success of the treatment of pediatric medulloblastoma brain tumor depends largely on the fact that
Has the tumor been completely removed during surgery and whether the tumor has spread to other parts of the brain or spinal cord.
In addition, the surgeon’s expertise and experience will have a significant impact on the success rate of brain tumor surgery and treatment outcome.
Therefore, it is recommended that you choose the best neurosurgeon in Iran to treat the disease before starting treatment.

What is medulloblastoma?

Meduloblastoma is a type of brain tumor located in the cerebellum. The cerebellum is the part of the brain that controls balance, coordination, and other complex motor functions.

Medulloblastoma generally grows in the central part of the cerebellum and is rarely seen in the outer parts of the cerebellum.

15-20% of pediatric brain tumors are medulloblastoma.

Meduloblastoma is most commonly seen in children 3 to 8 years of age, although this brain tumor has been reported at other ages.

Causes of Medoblastoma brain tumor

The cause of medulloblastoma in most cases is unknown. Some cases of medulloblastoma are caused by the following inherited diseases:

Lee Framney Syndrome
Mumps basal cell carcinoma syndrome (Gorlin syndrome)
Torkat syndrome

It should be noted that medulloblastoma tumors and other brain tumors usually develop for no apparent reason. So there is no way to prevent them from forming.

Symptoms of medulloblastoma cancer

The most common symptoms of medulloblastoma are:

A headache that usually starts in the morning when you wake up.
Nausea and vomiting
Fatigue
Lethargy
Imbalance and lack of coordination
Problems with motor skills, such as writing
Neck tilt or diplopia
Personality or behavioral changes
Convulsions

Medulloblastoma also rarely spreads to the central nervous system or spinal cord and causes the child to have the following symptoms:

Loss of strength of the lower torso
back ache
Urinary and fecal incontinence and loss of bowel or bladder control
Difficult to write

Diagnosis

The first step in treating pediatric medulloblastoma brain tumors is to make a complete and accurate diagnosis.

The pediatrician will order various tests to determine the type and location of the tumor.

In addition to clinical examination, medical examination and neurological examination, the following diagnostic tests are also performed.

Magnetic Resonance Imaging (MRI)

MRI is a diagnostic test that provides accurate images of structures inside the brain and spine.

MRI scans of the brain after surgery show how much of the tumor was removed during surgery.

Brain Tumor Surgery in Iran

After the tumor is removed, a sample is sent to a laboratory to confirm the diagnosis.
Although medoblastoma is seen on MRI scans, it is only the result of tissue sampling that confirms the diagnosis.

Histological diagnosis

A neuropathologist examines a tissue sample taken from a surgical tumor under a microscope to make sure it is a medulloblastoma.
If the child has a medulloblastoma tumor, a lumbar puncture test or cerebrospinal fluid biopsy is performed shortly after the initial surgery.
Your doctor will perform other tests if necessary.

Treatment of meduloblastoma in Iran

Third ventricular endoscopic ventriculostomy (ETV) or ventricular-peritoneal shunt (VP shunt)
A brain tumor blocks the cerebrospinal fluid, the fluid that surrounds the spinal cord and brain.
In this case, the neurosurgeon performs a procedure to relieve the symptoms of hydrocephalus and the accumulation of fluid that increases the pressure inside the skull.
In third ventricular endoscopic ventriculostomy, the surgeon makes a small hole for fluid to flow around the obstruction and into the spine.
This procedure is recommended for about 90% of children with symptoms of hydrocephalus.
Sometimes another operation called a peritoneal ventricular shunt is performed, in which a tube is used to drain excess fluid into the abdomen.

Brain Tumor Surgery in Iran

Sometimes surgery is needed to treat hydrocephalus (fluid accumulation in the skull) and to remove the tumor.
Research has shown that the more tumors removed, the better the treatment.
Therefore, the surgeon removes the tumor as much as he can and there is no risk of neurological side effects.

Radiotherapy

In radiation therapy of high-emission waves, a special device is used to damage and kill cancer cells and shrink the tumor.
The pediatrician, in collaboration with the pediatric oncologist, determines the optimal dose of radiation to provide effective treatment without severe side effects.

Chemotherapy

Drugs used in chemotherapy impair the ability of cancer cells to grow.

The mechanism of action of different chemotherapy drugs to fight cancer and shrink the tumor is different.

Pediatric chemotherapy is given in the following ways:

Orally, in the form of tablets to be taken.
Intramuscular, intramuscular or adipose tissue injection
Intravenous, direct injection of the drug into the bloodstream, for example through the serum
Intrathecal, direct injection of the drug with a needle into the spine

The probability of successful treatment Brain Tumor Surgery in Iran depends on the following factors:

Tumor molecular subtype (specific genetic mutations within the tumor)
The age of the child at the time of diagnosis
Tumor location
Remaining amount of tumor after surgery
Tumor spreads to other parts of the central nervous system (brain and spinal cord) or to other parts of the body such as bone

The success rate of pediatric medulloblastoma treatment has improved significantly over the past few decades.

Of course, the outcome of neonatal treatment is not yet promising, and many studies are underway to evaluate new neonatal treatment strategies, some of which focus on invasive chemotherapy (including high-dose chemotherapy and stem cell transplantation) and topical radiation therapy to minimize complications. Radiation therapy is growing on the brain.

الدکتور مهدي زينلی الزادة – استاذ جراحة المخ و قاعدة الجمجمة

Dr. Mehdi Zeinalizadeh – professor in brain surgery and cranial base

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