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Did you know that there are over 120 types of brain tumours – glioblastomas (GBM4s), meningiomas, astrocytomas, gliomas are just a few – all of which require different treatment options? In some cases surgery is necessary; in others it may just be question of watch and wait. But you need to know what the best course of action is. brainstrust can help you.

Glossary

Anaplastic oligodendroglioma: this tumour is more prevalent in adults in midlife. They appear to resist radiation but may respond to chemotherapy.

Artifact: images on an MRI scan that may be caused by movement during the scan, metal or a processing problem

Astrocytoma: this tumour rises from star-shaped glial cells called astrocytes. In adults, astrocytomas most often arise in the cerebrum. In children, they occur in the brain stem, the cerebrum, and the cerebellum. A grade III astrocytoma is sometimes called an anaplastic astrocytoma. A grade IV astrocytoma is usually called a glioblastoma multiforme.

Chordoma/chondrosarcoma: slow growing tumours most often detected in young adults. They rarely mestatasize and rarely cause symptoms. Surgery and radiation are the preferred treatment options.

Choroid-plexus carcinoma: rare tumours which occur in the ventricles in children. Surgery is the preferred treatment, followed by radiation.

Colloid cyst: these are curable lesions, which occur almost exclusively in adults and are best treated by surgical removal where possible.

Coronal image: an MRI image which splits the brain into front and back sections

Craniopharyngioma: a rare tumour that grows in the region of the optic nerve and hypothalamus. So whilst it is benign it can cause problems and treatment options depend on how much it is impacting on the person.

Decreased signal: objects that appear darker on an MRI scan

Enhanced MRI: an MRI after contrast, such as gadolinium, is given

Ependymoma: the tumour arises from cells that line the ventricles or the central canal of the spinal cord. They are most commonly found in children and young adults. Surgical removal of as much of the tumour as is possible is recommended, followed by radiation to prevent the spread of cells through the spinal column.

Epidermoid cyst: these are tumours which are really just pieces of skin enclosed in the brain due to a mistake in fetal development. You sometimes hear stories in the press about a foot being found in a brain – this would be an epidermoid cyst. Surgery is usually for first course of action to remove as much as is possible.

Flair sequence: a way of doing MRI that is sensitive to water in the brain. It tells if there is swelling around the tumour

Gamma rays: electromagnetic radiation emitted during radioactive decay and having an extremely short wavelength

Gangloglioma: we know this little beastie well. This is what Meg had. It is mixed cell glioma and the best chance of a cure is complete resection. If the tumour grows back then further therapies are recommended.

Germ cell tumours: there are subdivisions of this tricksy tumour. Most are treated with surgery, radiation and chemotherapy. The tumour arises from a germ cell and most germ cell tumors that arise in the brain occur in people younger than 30.

Glioblastoma multiforme: often called a GBM4. These tumours develop in the cerebral hemisphere and spread quickly into the surroundng brain. They can be treated with a range of treatments. The goal with a GBM4 is to relieve the pressure created and to make the surrounding area unfavourable for continued growth. For a comprehensive overview of a GBM4 visit www.btbuddies.org.uk

Hemangioblastoma: a rare benign tumour composed of cells from the lining of the blood vessels. These can usually be removed through surgery.

Increased signal: objects that appear whiter on an MRI scan

Medulloblastoma: this tumour usually arises in the cerebellum. It is the most common brain tumour in children, particularly in ages of 5 to 9 years. The more that can be removed the better. Chemotherapy and craniospinal radiation may be used post surgery. A primitive neuroectodermal tumour resembles a medulloblastoma in appearance and has the same treatment options.

Meningioma: this tumour arises in the meninges and is relatively common. It usually grows slowly and often shows no symptoms but often can be removed safely with surgery. Sometimes observation is the best approach if there are no symptoms.

Neoplasm: new or abnormal growth that is uncontrolled and progressive

Oligodendroglioma: this rare tumour arises from cells that make the fatty substance that covers and protects nerves. These tumours usually occur in the cerebrum. They grow slowly and usually do not spread into surrounding brain tissue. They are most common in young to middle-aged adults. The best treatment is to remove as much as possible and then treat with further therapies if it begins to grow.

Photon: a particle that travels at the speed of light

Pilocytic astrocytoma: the most benign type of astrocytoma which occurs primarily in children and adolescents. Treatment depends on position.

Pineal region tumour: this rare brain tumour (but more common in children) arises in or near the pineal gland. The pineal gland is located between the cerebrum and the cerebellum. Pineal tumours are classified as either pineocytomas (grade II) that grow slowly or pineoblastomas (grade IV) which are more aggressive. Treatment options include surgery followed by radiation and chemotherapy.

Pituitary adenoma: this develops in the pituitary gland and is generally benign. Treatment options depend on the type of pituitary tumour, but drug therapy or surgery are the usual routes.

Positron emission tomography (PET): a nuclear medicine test in which tissue function is imaged. Damaged tissues have reduced metabolic activity, therefore gamma radiation from these areas is reduced or absent

Positron: an electrically charged particle that has the opposite charge as an electron. It reacts with an electron to produce gamma rays.

Radiolabel: the technique of attaching, or "tagging", a radioactive molecule to another molecule (such as a protein) so that it can be identified in the body.

Sagittal image: a sideways MRI image that splits the brain into left and right sections

Schwannoma or acoustic neuroma: a tumour that arises from a Schwann cell. These cells line the nerve that controls balance and hearing. This nerve is in the inner ear. The tumour is also called an acoustic neuroma. It occurs most often in adults and is benign. Watch and wait, surgery or radiation are the preferred course of action, depending on the size and symptoms.

Tomography: the technique of using rotating X-rays to capture an image at a particular depth in the body, bringing those structures into sharp focus while blurring structures at other depths.

Tracer: a substance, usually radioactively labelled, which is injected into your body and can be followed to gain information about metabolic processes.

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