The base of the skull is that part of your head on which your brain lies. It is made of multiple bones which are fused together with sutures. It is a complex region of the brain, because all the blood vessels supplying the brain traverse through the base of the skull in order to reach the other parts of the brain. Even most of the critical nerves supplying the rest of the body pass through the base of the skull. From the outside, the base of the skull is somewhere in the region behind your eyes and nose. Therefore tumors which arise in this part of the head, require complex procedures which have to be done with extreme precision in order to obtain the desired results and prevent adverse consequences of surgery. Therefore you want someone with experience and adequate knowledge to handle the surgery for you, and Dr. Vikas Kathuria, the best neurosurgeon in Rohtak, is the person you want to go to. With vast experience and the skill of performing these complex procedures, he is well known as an expert in brain tumor surgery in Rohtak.
Yes, not all skull base tumors are the same, and they differ from one another in the basic way, which is whether it is a primary brain tumor, arising from the brain tissue itself, or if it is a secondary deposit from a tumor which has spread from elsewhere in the body. Furthermore, primary skull based tumors are also differentiated according to the type of brain tissue they arise from. For example the different types of brain tumors include, Chondrosarcoma, Chordoma, Schwannoma, Meningioma, Pituitary tumor, Glomus jugulare and Craniopharyngioma. Depending on the type of tumor, the size of the tumor and its precise location, the type of procedure done to remove it will vary.
There are certain symptoms which are common to all skull base tumors, they include:
- Nausea and vomiting
- Severe headache, which are frequent
- First-time seizures
- Drowsiness and altered levels of consciousness
- Changes of voice and hoarseness and voice
- Hearing disturbances and even loss of hearing
- Tinnitus/ringing in the ears
- Difficulty with balance and coordination
- Speech difficulties
- Difficulty swallowing
- Facial pain
- Twitching, or paralysis of the facial muscles
It is not necessary that everyone who develops a skull base tumor, presents with the above mentioned symptoms. Most people will have only some of them. But if you have developed any of the above, mentioned symptoms, it should raise concern, and you should discuss this with your doctor.
There are also other symptoms which are specific and characteristic of certain types of skull base tumors. For example, a pituitary tumor has characteristic features which are not seen in any other type of skull base tumor, and they include:
- Rounding of the face
- Very tall stature
- Disproportionate face, hands and feet
- Joint pains
- Increased blood pleasure
- Easy bruising
- Presence of stretch marks
- Excessive sweating
No specific cause has yet been identified for the development of these tumors. And they are thought to be multifactorial in origin. Certain factors such as exposure to particular types of chemicals, exposure to radiation and a strong family history of similar brain tumors have been associated with an increased risk of developing skull base tumors.
Diagnosis of this condition is made using a complete history and physical examination, which give your doctor clues regarding the condition you may be suffering from. But investigation such as imaging techniques remain the mainstay of diagnosing a skull base tumor. These investigations include:
- CT Scan
- Dynamic MRI
- Functional MRI
- Dynamic CT Scan
- FS MRI
- Cerebrospinal fluid examination
- Endocrine evaluation
- Stereotactic biopsy
There a number of treatment options when it comes to the management of skull base tumors, such as:
- Pharmacological therapy/medication
- Placement of a shunt
- Other therapies, such as radiotherapy and chemotherapy
Which form of treatment a patient undergoes depends on the exact tumor they have, the precise location and other factors such as the general health condition of the patient. Sometimes your doctor may suggest that you undergo a combination of treatments, in order to achieve better outcomes.
Brain tumor surgery has long been the treatment of choice when it comes to skull base tumors, with craniotomy, where the surgeon makes a small incision on the skull and tumor is removed through this, being the most common. But with the development of innovative techniques such as minimally invasive microsurgery, surgeons prefer to avoid surgery as much as possible, considering the risks involved. A shunt is long, thin tube which is placed inside you skull in order to remove excessive cerebrospinal fluid, which is collecting within the cranial cavity. This tube is connected from the brain to the abdomen, allowing the fluid to drain into the abdomen, to relieve the pressure build up within the skull.