Author(s): Prathima Gujjaru1, N. Saila Rekha2, Syam Sunder Rao Uttarakar3
Brain neoplasms occur at all ages and account for around 2-3 percent of all deaths in adults. In children, the frequency increases to more than twenty percent. In children, it forms the second most common type of malignancy. Most of the tumours encountered are not related to any identifiable risk factors except for irradiation and some hereditary syndromes like subependymal giant cell astrocytoma, glioblastoma multiforme, cerebellar haemangioblastoma, meningioma, Schwannoma of 7th cranial nerve. Gliomas constitute fifty percent of the brain tumours and sixty percent of all gliomas are glioblastoma multiforme. Meningiomas constitute twenty percent and cerebral metastasis is seen in fifteen percent of the cases. Seventy percent of supratentorial tumours are found in adults and seventy percent of brain tumours in children are infratentorial. The three common tumours of cerebellum are medulloblastoma, haemangioblastoma and juvenile pilocytic astrocytoma. Brain tumours are space occupying lesions and cause compression and destruction of adjacent structures, brain oedema (Peritumoural tissue), infarction and ischaemia of brain by compressing/infiltrating cerebral blood vessels, obstruction of CSF flow causing hydrocephalus, and rise in intracranial pressure with herniations. Tumours can undergo ischaemic necrosis and necrotic tumours tend to bleed. Brain tumours generally do not metastasise. Schwannoma and meningioma are benign tumours. Medulloblastoma of childhood may have drop metastasis via CSF. A sincere effort has been put in this study to identify the incidence of each variety of brain tumour among the fifty confirmed and identified cases of brain tumours.
The age range of the cases in present study was 5-72 years with a mean age of occurrence of 44.11 years and the peak age group affected were in the 3rd and 4th decades. Cerebral hemisphere was the commonest site for intracranial tumours.
In the present study, fifty six percent of the cases were of neuroepithelial in origin. Twenty eight percent were meningiomas. Only one case was metastatic in origin and in two patients the pituitary adenomas were confirmed. The study is in agreement with the other studies when compared.
Cerebrum was the commonest site of intracranial tumours. Neuroepithelial tumours were the most common histological type followed by pituitary tumours and meningiomas. Majority of malignant intracranial tumours were WHO grade I. Rare variant like clear cell type was also observed. Most meningiomas were of grade I, but most astrocytomas were of higher grade.