Columbia Neurosurgery » meningioma

Another Study: Still No Link between Cell Phone and Brain Tumor

Department Author — Mon, 28 Dec 2009 09:18:54 +0000

Despite the lack of evidence so far, the suggestion that cell phone use is in some way linked to the development of brain tumors still abounds, prompting study after study. Newly published research out of Scandinavia, where cell phone use is particularly high, shows that there is still no link. Several years ago, our own Dr. Jeffrey Bruce from the Brain Tumor Center and his colleagues came to the same conclusion in a study they published in Neurology.

The recent article in the Journal of the National Cancer Institute details a retrospective comparison of the rates of brain tumors in Scandinavia with the rise of cell phone use since the 90′s. In particular, they looked to see if the incidence of gliomas and meningiomas, two types of brain tumor, increased between 1974 and 2003. Here is what they found:

From 1974 to 2003, brain tumor incidence rates in Denmark, Finland, Norway, and Sweden were stable, decreased, or continued a gradual increase that started before the introduction of mobile phones. No change in incidence trends was observed from 1998 to 2003, the time when possible associations between mobile phone use and cancer risk would be informative about an induction period of 5–10 years. JNCI

Similarly, Dr. Bruce and his colleagues performed a retrospective study in 2002 that compared 90 people who were diagnosed with Acoustic Neuromas, tumors near the ear, against a group of 86 without. They gathered information from each person like: whether they even used a cell phone, how many minutes they talked per month, how long they had the phone, and which ear did they normally hold the phone to. Not only was there no correlation between those that had tumors and any cell phone use but there was a tendency for people to have tumors on the other side of the head than they usually held their phone.

As more time passes, the use of cell phones increases, and more research is done, then perhaps a connection will be made but by then it is quite possible that a newer technology will have developed for us to worry about. Besides, with hands-free and texting who is going to be holding their phone to their ear anyway?

*See Dr. Bruce‘s and his colleagues’ paper: Handheld cellular telephones and risk of acoustic neuroma in Neurology 2002;58:1304-1306

Grace K. Mandigo, M.D.

Brigitte Matsuoka — Tue, 27 Oct 2009 01:13:35 +0000

Dr. Mandigo completed her undergraduate education at Yale University where she graduated magna cum laude, and she earned her medical doctorate from Columbia, College of Physicians and Surgeons. She completed her Neurological Surgery Internship, Residency and Chief Residency at the Neurological Institute of New York, Columbia University.

Dr. Mandigo’s practice is devoted to degenerative spine disease, intervertebral disc disease, brain tumors, meningiomas, acoustic neuromas, microvascular decompression for trigeminal neuralgia and hemifacial spasm, hydrocephalus, and treatment of cerebrovascular disease, including carotid stenosis and vascular malformations.

Dr. Mandigo directs our Allen Hospital practice based in Northern Manhattan. Her main office is located at the Allen Hospital at the corner of Broadway and 220th Street.

Medical School:	College of Physicians and Surgeons, Columbia University, 2003
Residency Training:	Columbia University Neurological Institute of New York

Video

Spinal Meningiomas

Brigitte Matsuoka — Thu, 06 Aug 2009 03:18:33 +0000

The spinal cord is surrounded by a protective membrane called the meninges, which is made up of three layers, the dura mater, the arachnoid membrane, and the pia mater. Tumors that arise from this tissue, especially the cells that make up the arachnoid membrane (arachnoid cap cells), are called meningiomas. Meningiomas usually are benign, slow-growing tumors, although in rare cases they may be malignant and invade surrounding tissue.

Meningiomas account for approximately 25% of spinal canal lesions. They can occur at any location throughout the spine, but predominate in the thoracic region (probably because this is the largest segment).

Spinal Meningiomas occur approximately four times as often in women as in men, and the average age is 45 years.

Symptoms

The symptoms of a meningioma are caused by the pressure the growing tumor exerts on surrounding tissue. These tumors can occur in a variety of places and therefore cause a wide range of symptoms. Depending on the location of the mass, meningiomas may cause headaches, nausea, seizures, weakness or numbness in the limbs or face, visual problems, and gradual changes in mood or personality. The symptoms tend to increase in severity as the tumor grows in size.

Diagnosis

Imaging studies are the key component in the diagnosis of meningiomas. Computed tomography (CT) and magnetic resonance imaging (MRI) scans are used to provide detail about the tumors size, location, and effect on surrounding structures. In addition, an angiogram, which allows physicians to visualize the blood vessels in the area, may be used.

Treatment

If a meningioma is small and does not cause symptoms, it may be observed over time rather than treated immediately. In cases in which treatment is necessary, the first line of treatment for these tumors usually is surgery. Because the tumors are benign, complete resection often results in a cure. Some tumors, however, may be difficult to remove completely. In addition, meningiomas may recur even in cases of complete resection. When a tumor is removed, it can be examined under a microscope to assess the risk of recurrence and dictate the next step in treatment. Radiation therapy may be used as a follow-up treatment, especially for malignant tumors but it is not recommended for children under the age of two. In addition, stereotactic radiosurgery, which involves the use of a highly focused beam of radiation to target the tumor, may be used as either primary or adjunct treatment. Chemotherapy has yet to show benefits for children with meningiomas, although treatments that affect hormonal processes are being investigated because these tumors are believed to have some hormonal involvement.

Meningiomas

Brigitte Matsuoka — Thu, 06 Aug 2009 02:51:38 +0000

The brain and spinal cord are surrounded by a protective membrane called the meninges, which are made up of three layers, the dura mater, the arachnoid membrane, and the pia matter. Tumors that arise from this tissue, especially the cells that make up the arachnoid membrane (arachnoid cap cells), are called meningiomas. Meningiomas usually are benign, slow-growing tumors, although, in rare cases, they may be malignant and invade the surrounding brain tissue. These tumors are relatively common, making up 15 to 20 percent of all primary brain tumors, and can occur anywhere on the meninges. The tumors can occur in anyone, but they appear to be most common in middle-aged women.

Symptoms

The symptoms of a meningioma are caused by the pressure the growing tumor exerts on surrounding tissue. These tumors can occur in a variety of places and therefore cause a wide range of symptoms, although they tend to occur in specific regions around the brain. Depending on the location of the mass, meningiomas may cause headaches, nausea, seizures, weakness or numbness in the limbs or face, visual problems, and gradual changes in mood or personality. The symptoms tend to increase in severity as the tumor grows in size.

Diagnosis

Imaging studies are the key component in the diagnosis of meningiomas. Skull x-rays can be used to spot a meningioma, and computed tomography (CT) and magnetic resonance imaging (MRI) scans are used to provide increased levels of detail. An angiogram, which allows physicians to visualize the blood vessels in the area, may also be used.

Treatment

If a tumor is small and does not cause symptoms, it may be observed over time rather than treated immediately. In cases in which treatment is necessary, the first line of treatment for meningiomas usually is surgery. Because the tumors are benign, and rarely invade the surrounding brain tissue, complete resection often results in a cure. Some tumors, however, may be difficult to remove completely, especially those that occur near important structures at the base of the skull. In addition, meningiomas have a tendency to recur even in cases of complete resection. When a tumor is removed, it can be examined under a microscope to assess the risk of recurrence and dictate the next step in treatment. Radiation therapy may be used as a follow-up treatment, especially for malignant tumors. In addition, stereotactic radiosurgery, which involves the use of a highly focused beam of radiation to target the tumor, may be used as either primary or adjunct treatment. Chemotherapy has yet to show benefits for patients with meningiomas, although because the tumors are believed to have some hormonal involvement, treatments that affect this process are being investigated.

Intraventricular Tumors

Brigitte Matsuoka — Thu, 06 Aug 2009 02:48:34 +0000

Within the brain there are several ventricles, or cavities, that are filled with a clear liquid called cerebrospinal fluid. The cerebrospinal fluid, which also surrounds the brain and spinal cord, helps support and cushion the brain. Tumors in the ventricles are known as intraventricular tumors, and they may arise from a variety of cells in the region. The tumors may be astrocytomas, which arise from supporting cells in the brain; meningiomas, tumors of the protective covering of the brain; ependymomas, which arise from the linings of the ventricles themselves; colloid cysts and craniopharyngiomas, which arise from developmental cells; or other brain tumors. As a whole, intraventricular tumors make up 10 percent of tumors in the central nervous system.

Symptoms

Intraventricular tumors are especially significant because they often obstruct the flow of cerebrospinal fluid. When the flow of cerebrospinal fluid is blocked, it is a condition known as obstructive hydrocephalus. In people with hydrocephalus, the volume of fluid in the ventricle increases, placing pressure on surrounding brain tissue and leading to headache, nausea, mental status deterioration, visual disturbances and death. Intraventricular tumors can cause other symptoms depending on location, including seizures, weakness or numbness in the limbs, impairments in language function, gradual changes in mood or personality, and memory loss.

Diagnosis

Imaging studies are the key component in the diagnosis of intraventricular tumors. Currently, magnetic resonance imaging (MRI) is the best available imaging modality. Computed tomography (CT) scans also are used, especially to assess hydrocephalus. For either study, an agent that provides contrast in the image is administered intravenously so neurological surgeons can visualize the tumor against the normal brain in the background. In some cases, neurological surgeons may employ an MRI scan with frameless stereotactic guidance. For this study, a contrast MRI is performed after special markers (called fiducials) are placed on the patient’s scalp. The fiducials are processed by a computer, which calculates the location of the tumor and creates a three-dimensional reconstruction. This image then is used at the time of surgery to help locate the tumor precisely, maximize tumor removal, and minimize injury to the surrounding brain.

Treatment

Traditional treatment for intraventricular tumors often begins with the alleviation of the pressure caused by the obstruction in cerebrospinal fluid flow. Surgical tumor resection, the main treatment for brain tumors, can relieve the pressure as well as remove the obstruction. In some cases, the excess fluid must be drained off before surgery. This can be done with a shunt, an implantable tube that allows the excess fluid to drain to other parts of the brain or elsewhere in the body. Endoscopic surgery, in which instruments and cameras are manipulated through tubes inserted in a small incision, is useful for intraventricular tumors for several reasons. Cerebrospinal fluid is clear, making it easy for surgeons to visualize the tumor through an inserted camera. Also, because these tumors may arise from a wide variety of cells, a tissue biopsy often is necessary; with endoscopic surgery this can be done without requiring a craniotomy. Finally, intraventricular tumors may be hard to reach with conventional surgical techniques, a restriction that does not apply to endoscopic surgery.

A biopsy taken before or after surgery will be examined under a microscope to determine the tumor type and malignancy, and dictate follow-up treatment. Following surgery, patients may be treated with radiation therapy, chemotherapy, or both. In addition, some smaller tumors may be treated effectively with stereotactic radiosurgery, which involves the use of a highly focused beam of radiation to target the cancer cells specifically and leave the surrounding brain unaffected

Anthony L. D’Ambrosio, M.D.

Brigitte Matsuoka — Tue, 04 Aug 2009 16:41:02 +0000

Dr. D’Ambrosio earned his medical doctorate from the Vanderbilt University School of Medicine where he graduated Alpha Omega Alpha. He completed his Neurological Surgery Internship, Residency and Chief Residency at the Neurological Institute of New York, Columbia University. In addition, he completed a Skull Base and Cerebrovascular Surgery Fellowship in the Department of Neurological Surgery at the University of South Florida in Tampa.

Dr. D’Ambrosio’s practice is devoted to brain tumors, skull base tumors, meningiomas, acoustic neuromas, pituitary tumors, microvascular decompression for trigeminal neuralgia and hemifacial spasm, cerebral aneurysm treatment, degenerative spine disease, and intervertebral disc disease.

He uses state-of-the-art technology such as frameless image guidance systems, awake craniotomy, and stereotactic radiosurgery (i.e. GammaKnife, BrainLab, Tomotherapy) for the treatment of primary and metastatic brain tumors. He has particular expertise in the use of endoscopic techniques to remove complex intracranial tumors at the base of the brain.

Dr. D’Ambrosio directs our Northern New Jersey practice based in Ridgewood, NJ. He is the Director of Neuro-Oncology – Disease Management Team at the Luckow Cancer Center of The Valley Hospital in Ridgewood, NJ. Dr. D’Ambrosio is also the Director of Neurosciences for the St. Joseph’s Healthcare System in Paterson and Wayne, NJ. He sees patients at The Valley Hospital, St. Joseph’s Regional Medical Center, St. Joseph’s Wayne Hospital, Chilton Memorial Hospital, and Mountainside Hospital. With his main office in Ridgewood, New Jersey, Dr. D’Ambrosio has helped to establish a center of excellence for Columbia Neurosurgery in the communities of Bergen, Passiac and Essex counties.

Board Certified:	American Board of Neurological Surgery
Medical School:	Vanderbilt University School of Medicine, Nashville, T.N, M.D. 1999
Residency Training:	Columbia University Neurological Institute of New York
Fellowship Training:	Cerebrovascular and Skull Base Surgery, The University of South Florida, Tampa General Hospital

Michael B. Sisti, M.D., F.A.C.S.

Brigitte Matsuoka — Tue, 04 Aug 2009 16:38:43 +0000

Dr. Sisti specializes in the treatment of complex brain tumors, meningiomas, and acoustic neuromas employing state of the art computer guided microneurosurgery and Gamma Knife radiosurgery. Dr. Sisti’s core belief is that by dedicating himself both to the best in medical technology and to the quality of the physician patient relationship, he provides the optimum opportunity for helping patients deal with these difficult brain tumors. He has safely and successfully operated upon more than four thousand patients with these complex conditions. During his 30 year career in the Department of Neurosurgery at Columbia University’s world-class medical center Dr. Sisti has also pioneered many surgical and technical advances including New York City’s first non-invasive radiosurgery program. As a result of his personal philosophy and the long term concentrated experience in treating the most difficult tumors Dr. Sisti has earned a reputation for technical excellence in surgical results as well as providing superior personal care to his patients and their family members.

Learn more here: The Making of a Neurosurgeon: Dr. Michael Sisti

Dr. Sisti’s Bio featured in The Cooper Union Summer 2010 Issue

They Walk in the Shoes of Giants and Even Sit in Their Chairs

Board Certified:	American Board of Neurological Surgery
Medical School:	College of Physicians & Surgeons, Columbia University, A.O.A., M.D. 1981
Residency Training:	Columbia University Neurological Institute of New York
Fellowship Training:	National Institutes of Health

Video

2010 Columbia University Medical Center Attending Physician of the Year Award

Dr. Sisti on Senator Kennedy’s brain tumor

Interview with Katie Couric

Interview with Meredith Vieira

Links

Dr. Sisti’s Bio featured in The Cooper Union Summer 2010 Issue

Patient Story: Waiting For Michael