| Metastatic brain tumors may be quite | | | | MRI Angiography (MRA) uses MRI scans to |
| aggressive and may return even after surgery, | | | | outline blood vessels in the brain by |
| radiation therapy, and chemotherapy. | | | | following blood flow. Angiography is used to |
| | | | plan the surgical removal of a tumor |
| Metastatic disease requires treatment of the | | | | suspected to have a large blood supply or one |
| original tumor site if applicable. Some | | | | located in a part of the brain with?dense |
| primary brain tumors respond to certain forms | | | | blood vessels. |
| of therapy better than others. Metastatic | | | | |
| brain tumors are classified depending on the | | | | Contrast agent uptake, sometimes in |
| exact site of the tumor within the brain, | | | | characteristic patterns, can be demonstrated |
| type of tissue involved, original location of | | | | on either CT or MRI-scans in most malignant |
| the tumor, and other factors. | | | | primary and metastatic brain tumors. This is |
| | | | due to the fact that these tumors disrupt the |
| Infrequently, a tumor can spread to the | | | | normal functioning of the blood-brain barrier |
| brain, yet the original site or location of | | | | and lead to an increase in its permeability. |
| the tumor is unknown. Metastatic brain tumors | | | | |
| occur in about one-fourth of all cancers that | | | | Now neurological progression can be |
| metastasize (spread through the body). They | | | | effectively controlled in most patients |
| are much more common than primary brain | | | | harboring a few intracranial metastases with |
| tumors . | | | | aggressive focal treatment (surgery or |
| | | | radiosurgery) in combination with WBR. |
| Astrocytomas may also start here. | | | | |
| Astrocytomas are generally subdivided into | | | | WBR can be given immediately following focal |
| high-grade or low-grade tumors. High-grade | | | | treatment or at the time of recurrence. |
| astrocytomas are the most malignant of all | | | | Control can be extended by frequent MR |
| brain tumors. | | | | surveillance of the brain and radiosurgical |
| | | | treatment of new metastases months or years |
| Ependymomas make up about 8-10% of pediatric | | | | later. With control of intracranial disease, |
| brain tumors. The tumors are located in tiny | | | | advances in cancer therapy will prolong |
| passageways (ventricles) in the brain, and | | | | survival, since most patients now succumb |
| block the flow of cerebrospinal fluid (CSF). | | | | later to systemic, rather than intracranial |
| Ependymomas can be slow growing, compared to | | | | disease. |
| other brain tumors, but may recur after | | | | |
| treatment is completed. Recurrence of | | | | Aggressive, focal treatment is only |
| ependymomas results in a more invasive tumor | | | | beneficial in patients with controlled or no |
| with more resistance to treatment. | | | | systemic disease and independent health |
| | | | (Karnofsky Performance Score (KPS) 70). Age |
| Contrast dye is intravenously administered | | | | is also a determinant of outcome, with better |
| and the scanner starts taking a rapid | | | | outcomes in individuals less than 60 years |
| succession of images this traces the path of | | | | old. |
| blood flow into the brain and brain tumor. | | | | |