Cerebrospinal Fluid (CSF)
A clear fluid that is produced in the ventricles within the
brain. The fluid circulates through the ventricular system and around the outside of the
brain and spinal cord. It functions as a cushion to prevent injury and it also provides the
brain and spinal cord with nutrients. Obstruction of this pathway may cause
hydrocephalus.
Chemotherapy
Drug Therapy. The term chemotherapy is commonly used to describe
the drugs used to treat cancer. Depending on the type of tumor, the drug or drugs will
vary in the amount and frequency with which they are given. They may be given
through an intravenous tube, by mouth or other route. They are prescribed by a
physician but may be given by a specially trained nurse.
CNS
Central Nervous System. Referring to the brain and spinal cord.
Cognition
A generic term involving perceiving, recognizing, conceiving, judging,
sensing, reasoning, remembering and imagining. (Adjective: cognitive)
Congenital
Existing before birth.
Corticosteroids
Drugs used to decrease swelling (edema) around tumors. See the chapter
on Decadron.
Craniectomy
An operation in which the skull is entered by removing small pieces of
bone to gain access to the brain. This is used for tumors of the posterior fossa. Unlike a
craniotomy, the removed pieces of bone are not reinserted into the skull. Following
surgery, a soft spot may be felt in the area of the scar.
Cranioplasty
An operation in which a bony defect in the skull is replaced by plastic.
This may occur during the initial operation or may be delayed months or years if reason
for bone removal was related to a tumor or infection involving bone.
Craniotomy
An operation in which the skull cavity is entered by removing a piece of
bone to gain access to the brain. This bone is replaced at the end of the surgical
procedure.
CSF
See Cerebrospinal Fluid.
CT or CAT Scan
Computerized Axial Tomography. A CT scan is an X-ray often taken
of the head, spine or chest. It is done in the Radiology or X-ray Department. Your child
will be on a narrow table and may have straps across his/her body to maintain position.
A radiologist may inject a contrast agent or dye a vein in the arm (enhanced CT Scan).
The table will be moved so that the part of the body to be X-rayed will be situated
within the tubelike or doughnut-shaped X-ray machine. The X-ray machine is called the
CAT or CT scanner. While X-rays are taken, the hum of the machine may be heard. A
head scan may take fifteen (15) minutes. A spine scan takes approximately thirty (30)
minutes.
Your child may be alone in the room for this procedure but the technician will be in an
adjacent room and will be able to see him/her and offer reassurance if necessary.
Generally, children under the age of 5 must be "asleep" or sedated for this procedure.
Using computers, the CT or CAT scanner makes a series of pictures that will help the
doctor follow your child's progress.
Cyst
A cavity, usually filled with a fluid, sometimes associated with benign or malignant
tumors.
Digital Subtraction Angiography
A type of angiogram where a contrast agent is
given intravenously using special techniques which can remove bony images. One is
left with an image of the blood vessels.
Dilantin
Phenytoin. Prescribed to control seizures and convulsions. It is extremely
important that it be taken regularly as prescribed by your physician. Should you forget
to give your child the medication, do so as soon as you remember. Do not stop this
medication on your own.
Dilantin may make your child feel dizzy, drowsy or lethargic, especially after he/she
has initially started taking it.
Dilantin may affect blood sugar levels. Your doctor will check this periodically,
especially if your child is a diabetic.
Gums may become swollen and reddened. Brush and floss your child's teeth faithfully
to prevent this from happening. Regular dental checkups are recommended.
Report any of the following to your physician: skin rash; unsteadiness while walking;
excessive fatigue; yellow coloring of eyes or skin; easy bruising or bleeding;
uncontrolled eye movements.
If your child is to stop taking Dilantin, you should do so in gradually decreasing doses.
Always follow your doctor's directions carefully with respect to this. Periodically the
physician will order a blood test to ascertain the level of this drug in your child's blood.
Diplopia
Double vision.
DIVA
Digital intravenous angiography. Similar to an angiogram, this test is also used to
visualize the blood vessels in the head. The difference is that the dye is injected into a
vein, usually in the arm and there is a waiting period before the X-ray pictures are
taken. The dye moves through the veins to the heart and then to the arteries that supply
the brain. It is sometimes used if an angiogram cannot be performed, and works using
computer technology.
Dura
The outer membrane covering the brain.
EEG
Electroencephalogram. A test that measures the electrical activity in the brain.
Small electrodes are attached to the scalp. A machine will record the electrical activity
as brain cells send signals or messages to one another. Abnormal signals can be
detected from the tracings made by the machine. These abnormal signals may indicate
that there is seizure activity occurring or that damage has occurred to the brain cells in a
particular region of the brain. Medications may be prescribed to control the abnormal
activity.
Fistula
An abnormal connection between two structures or organs.
Gastronomy (G-tube)
A tube inserted into the stomach for feeding purposes if
swallowing is a problem.
Gravol (Dimenhydrinate)
This medication is used to treat nausea and vomiting. It is
often used for the relief of motion sickness. This drug commonly produces drowsiness.
Dizziness or dry mouth may occur. This may be helped by sucking on ice chips.
Gross Total Resection (GTR)
No evidence of residual or remaining tumor on
postoperative scans.
Health Care Professional
Any medical team member involved in your care. eg.:
nurse, physician, dietitian, pharmacist, physiotherapist, occupational therapist, social
worker, psychologist.
Hemiparesis
Muscle weakness on one side of the body; may be permanent or
temporary.
Hemiplegia
Complete paralysis on one side of the body. This may improve with time.
Hydrocephalus
"Water on the brain". Cerebrospinal fluid, also known as CSF, is found
within the brain and spinal cord. It is a watery substance that helps cushion the brain
and spinal cord from injury. This fluid circulates through channels and around the brain
and spinal cord, constantly being absorbed and replenished. It is within the hollow
channels in the brain, called ventricles, that the fluid is produced. The brain normally
maintains a delicate balance between the amount of cerebrospinal fluid that is absorbed
and the amount that is produced. Often, disruptions in the system occur.
Hypertension
Increased blood pressure.
Immune System
The body's defence system that protects it from foreign substances
such as bacteria and viruses that are harmful to the body.
Increased Intracranial Pressure
Increased pressure within the brain.
Infratentorial
The bottom portion of the brain, consisting of the cerebellum and brain
stem. Tumors of the posterior fossa are infratentorial.
Intrathecal
Medication is placed directly into the cerebrospinal fluid (CSF) through a
lumbar puncture, Ommaya reservoir or shunt.
Intravenous
A method of giving medicine, fluids or nutrition through a needle, small
tube, or butterfly placed directly in a vein.
Laser
A technique using focused light energy to evaporate tumors during surgery.
Lumbar Puncture (LP)
Also known as a Spinal Tap. A procedure during which
cerebrospinal fluid (fluid that circulates around the brain and spinal cord) is drawn from
the lower back. Spinal fluid is sent to various laboratories for analysis. The pressure
within the system may be measured. Excess fluid may be drained.
The procedure is conducted in the patient's room or a treatment room. To make the
drawing of the fluid easier, the patient may be told to assume a curled-up position which
widens the space between the vertebrae in the lower back. Vertebrae are the bony units
that make up the spinal column. They can be felt by rubbing your hand along the middle
of your back. The spinal tap is done in the lower back since the spinal cord, contained in
the vertebrae, does not reach this point. This reduces the risk of nerve damage. A doctor
wearing a mask and gloves will place a clean sheet or drape over the lower back. Your
child may find a cold feeling as the area is being washed. A local anaesthetic or freezing
applied with a needle will numb the area or a newly developed cream called EMLA
may be used in place of injection. A needle, into which the clear fluid will drain, is then
inserted. No pain is felt but a pressure feeling may occur. The procedure may take
fifteen (15) to thirty (30) minutes. Sample tubes of the spinal fluid will be taken as it
slowly drips from the back.
Following the tap children are often instructed to lie flat in bed for one to several hours
to decrease the chance of developing a headache.
Mild analgesics and sedatives may be given to the young child prior to the procedure.
MRI or NMR
Magnetic Resonance Imaging or Nuclear Magnetic Resonance. The MRI is
one of the latest means of obtaining detailed pictures of the body. Unlike X-rays, it does
not use radiation. It uses a magnet and radio waves to produce pictures of organs and
tissues of the body. The procedure is painless.
Since magnets are employed in the machinery, all metallic items are removed prior to
entering the testing area. eg. jewelry, wallets, pens, hairpins, safety pins, etc. A
technician will be interested in knowing if the patient has had previous surgery
involving metallic devices. eg. pacemakers, Port-a-Caths, shunts. This may affect the
mechanisms of the machinery.
For a MRI of the head, the head is secured with soft Velcro straps. It is important to
remain still throughout the procedure. Any slight movement will distort the final
photographs. In addition to Velcro straps, a windowed device, like a helmet, may also
be placed over the head. While the patient is lying on a flat narrow table, the table is
moved along into a narrow tubelike structure. The procedure may take one hour to
complete. While the images are taken, a drumming or banging noise may be heard. This
is normal. This noise does not become louder during the test, although the human ear
may interpret it as such. Ear plugs are often available for use. A technician is in another
room operating a computer. An intercom and mirror are in use during the procedure so
that the technician can see and hear the patient. Some patients find the machine to be
somewhat claustrophobic. A mild sedative will help to better tolerate the procedure.
Small children will require teaching and a sedative prior to having an MRI.
Malignant
Tending to grow quickly and spread causing harm to surrounding and/or
distant tissue.
Mannitol (Osmotrol)A medication given intravenously which reduces brain swelling.
It is usually used only in acute situations and may be used before and often after
surgery. The child will have to pass urine frequently if the drug is effective.
Metastases
The spread of cancer from a tumor elsewhere in the body. Sometimes
called a secondary tumor.
Nasogastric Tube (N-G tube)
A tube passing through the nose into the stomach for
purposes of feeding or drainage of gastric contents.
Neuroendocrinology
A scientific discipline involved in the study of the relationship
between brain function and hormonal control.
Neurologist
A physician specializing in nonsurgical diseases of the nervous system.
Neurooncologist
A physician who specializes in the treatment of tumors of the
nervous system.
Neuropathologist
A pathologist who specializes in the microscopic examination of
tissue from the brain and spinal cord.
Neuropsychologist
A psychologist who specializes in assessing brain function in
persons with central nervous system disorders. See the section on
Neuropsychology.
Neuroradiologist
A physician who specializes in the interpretation of images of the
brain and spinal cord. See Radiologist.
Neurosurgeon
A physician who specializes in surgery of the nervous system.
Nervous System:
The nervous system involves the brain, spinal cord and all of the
peripheral nerves that branch off from the spinal cord.
NPO
Nothing per os; os meaning mouth. For some diagnostic procedures (tests) and for
surgery, patients are often required not to eat or drink for a specified amount of time
prior to the procedure.
NSR (Neurological Signs Record)
Assessment of neurological function by the
measurement of blood pressure, temperature, pulse, respiratory rate, changes in eye
pupil size and reaction, change in motor function and orientation.
Oncologist
A physician who specializes in the study and treatment of cancer.
Opthalmologist
A physician who specializes in the diagnosis and treatment of eye
disorders. Also known as an eye specialist. Brain tumors may affect vision. An
opthalmologist is qualified to conduct eye surgery, such as in the case of strabismus. An
optometrist is a person qualified to prescribe eye glasses and contact lenses.
Optic Atrophy
A condition where the optic nerves at the back of the eye have a whitish
appearance. This is usually related to previous long-term direct pressure or long-term
increased intercranial pressure.
Osmotrol
See Mannitol.
Papilledema
Swelling of the optic nerve usually caused by pressure. This can be seen
during an eye examination and may be an indication of increased intracranial pressure,
possibly associated with a brain tumor.
Paralysis
Complete lack of function of specific muscle groups.
Paraparesis
Weakness of legs only.
Paraplegia
Paralysis of legs only.
Paresis
Weakness of specific muscle groups.
Pathologist
A specialist who attempts to describe the nature of a disease by analyzing
samples obtained from tissues, organs or body fluids. Samples or biopsy specimens of
brain tumors are surgically obtained by the neurosurgeon. Analysis of a brain biopsy is
a tedious procedure. A final report from the pathologist may not be available for three
or more days. It is the pathologist who carefully analyses the specimen and makes a
judgement on the diagnosis.
Phenobarbital
Anticonvulsant and sedative. This drug is used to treat seizures. It is
sometimes used for sedation or a sleeping pill. To effectively control your seizures, the
medication your doctor has prescribed must be taken as ordered.
Report the following to your doctor: dizziness; nausea and vomiting; skin rash,
pronounced drowsiness.
Periodically the physician will order a blood test to ascertain the level of this drug in
your child's blood.
Pituitary Gland
A gland situated at the base of the brain that controls the function of
many other glands.
Protocol
A standardized combination of therapies developed specifically for particular
tumors.
Quadriparesis
Weakness of both arms and legs.
Quadriplegia
Paralysis of both arms and legs.
Radiation Oncologist
A physician who specializes in the treatment of tumors by
radiation therapy.
Radiologist
A physician who specializes in the reading of X-rays and other images. The
radiologist may participate in administering a diagnostic procedure. eg. Angiography,
X-rays of the blood vessels in the brain. Dyes or contrast media may be injected by the
radiologist so that clearer X-rays may be obtained.
Radiotherapy/Radiation Therapy
Radiation. Radiation is an invisible beam
treatment used to cure or control cancerous tumors. Today, large cobalt or linear
accelerator machines produce gamma rays or electron beams which are then directed at
the tumor. For the patient, each treatment is an experience similar to a regular X-ray.
Radiation treatments usually follow surgery but may be used alone or in combination
with chemotherapy.
Stereotaxis
A method used to accurately find specific areas within the brain, using a
special frame, computer program and CT images.
Subtotal Resection
Removal of the majority, but not all of a tumor.
Supratentorial
The large top portion of the brain, consisting mainly of the cerebral
hemispheres.
Tegretol
Carbamazepine. This drug is commonly used to control seizures in children. To
effectively control the seizures, it is extremely important that this medication be taken
as prescribed by your child's physician. Periodically the physician will order a blood
test to ascertain the level of this drug in your blood.
Some stomach upset may occur. Give the medication with food or milk to prevent this.
Tegretol may cause drowsiness, especially during the first week. Do not give other
medications that cause drowsiness. eg. cold medications or tranquillizers without first
checking with your doctor.
Inform your child's physician of any of the following: drowsiness; unsteadiness;
dizziness; stomach upset; easy bruising; problems with vision; rash; fever and chills.
Ultrasound
A technique using sound waves which is used in the diagnosis of a wide
variety of conditions. In neurosurgery it may be used to localize a tumor during the
operation. It can help in the diagnosis of tumors in infants by placing the sensor directly
over the infants' soft spot (fontanelle). It does not work well over bone.
Ventricles
Small fluid-filled cavities within the brain. The site of production of
cerebrospinal fluid.
V-P Shunt and V-A Shunt
A plastic catheter with a reservoir used to divert
cerebrospinal fluid from the ventricles of the brain to the abdominal cavity or the heart.
See Shunts and Hydrocephalus.
Visual Fields
The amount a person can see in all directions with both eyes open and
looking straight ahead. Each eye has a right visual field and a left visual field. These
overlap the fields of the opposite eye. Tumors can cause damage to the visual pathways
within the brain causing loss of vision in part of the visual field. This may result in
blindness when looking in a certain direction. Any person with a visual field loss must
discuss this with his/her physician. Some adjustments may need to be made in regular
activities to compensate for a partial loss of vision.
Wound
This refers to any site where the skin has been cut and is undergoing a healing
process.
