Brain and Spinal Cord Tumours

Brain and spinal cord tumors are abnormal cell growths in brain or spinal cord tissues, which can be benign (slow-growing and non-spreading) or malignant (fast-growing and invasive).

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Dr Keith Goh

What are Brain and Spinal Cord Tumours

Brain and spinal cord tumours are abnormal growths of cells in the tissues of the brain or the spinal cord. These tumours can be either benign, meaning they grow slowly and do not spread to other parts of the body, or malignant, with rapid growth and the potential to invade surrounding tissues. Benign tumours can often be completely removed through surgery. On the other hand, malignant tumours may have less distinct boundaries, making complete removal challenging and requiring adjuvant radiotherapy and/or chemotherapy.

Types of Brain and Spinal Cord Tumours

Brain Tumours

Brain tumours encompass a variety of different types, each with unique characteristics and effects on the brain.

    • Optic Nerve Glioma: These tumours impact the optic nerves, which are necessary for vision, and are common in individuals with neurofibromatosis.
    • Pituitary Tumours: Occurring in the pituitary gland, these tumours can affect hormonal balance.
    • Glioma: Including types like astrocytoma, oligodendroglioma, ependymoma and glioblastoma, gliomas arise from glial cells in the brain.
    • Meningioma: These tumours develop from the meninges, the brain’s protective layers, and are usually slow-growing, but can cause headaches and limb weakness.
    • Posterior Fossa Tumours: Including medulloblastoma, haemangioblastoma and brainstem glioma; these tumours are located at the back of the brain.
    • Skull Base Tumours: Examples include acoustic neuroma and petroclival meningioma. They are found at the base of the skull.
    • Metastatic Tumours: These are secondary tumours that have spread to the brain from other parts of the body, such as lung or breast cancer.

Spinal Tumours

Spine tumours, while distinct from brain tumours, also present diverse challenges in diagnosis and treatment.

  • Extra-medullary Tumours: These include types such as neurofibroma, schwannoma, and neuroblastoma, which are outside the spinal cord, but within the spinal canal and column.
  • Intra-medullary Tumours: Tumours like ependymoma and astrocytoma, which are within the spinal cord.

Causes of Brain and Spinal Cord Tumours

The causes of brain and spinal cord tumours are multifactorial and not fully understood. Certain factors may contribute to the development of these tumours:

  • Genetic Disorders: Some genetic conditions, such as neurofibromatosis, have been linked to an increased risk of developing brain and spinal cord tumours.
  • Radiation Exposure: Exposure to ionizing radiation, such as those used in medical treatments or found in certain occupational environments, has been associated with a higher risk of tumours in the CNS.
  • Family History: Although not common, a family history of brain or spinal cord tumours can sometimes increase the likelihood of developing these conditions.
  • Age: While brain and spinal cord tumours can occur at any age, certain types are more common in specific age groups.
  • Chemical Exposure: Contact with certain chemicals, possibly those used in specific industries, may increase the risk of CNS tumours.
  • Immune System Disorders: Conditions that affect the immune system might also play a role in the development of these tumours.

Symptoms and

The symptoms and signs of brain and spinal cord tumours can vary widely, depending on the tumour’s type, size, location, and rate of growth.

  • Seizures and Neurologic Deficits: Sudden seizures, limb or facial weakness can be signs of brain tumours.
  • Altered Consciousness: Changes in consciousness, personality or cognitive abilities might indicate the presence of a brain tumour.
  • Paralysis: Tumours in certain areas of the brain or spinal cord can lead to partial or complete paralysis.
  • Brain Swelling: Indicators of brain swelling, such as headaches , double-vision or blurred vision can be associated with brain tumours.
  • Chronic Pain: Persistent pain, especially when associated with other neurological symptoms, can suggest a spinal cord tumour.


Diagnosing brain and spinal cord tumours typically involves the following steps:

  • Clinical Evaluation: Initial assessment by a neurologist or neurosurgeon – symptoms, medical history, and a physical examination.
  • Imaging Studies: CT and MRI scans can be used to provide detailed images of the brain and spinal cord, helping to identify the presence and characteristics of tumours. In some cases, techniques such as Spectroscopy and Perfusion studies, as well as PET scans may be used for more detailed insights into the tumour’s nature and behaviour.
  • Neurophysiological Testing: Tests like nerve conduction studies and electromyography may help assess the function of nerves and muscles, providing additional information about the impact of the tumour.

Surgical Treatment Methods

The surgical treatment of brain and spinal cord tumours involves techniques aimed at maximising tumour resection while minimising risks and complications.

  • Craniotomy and Microsurgical Techniques: These are the fundamental techniques in Neurosurgery, using intraoperative microscope and specialized instruments to remove the tumour.
  • Intraoperative image-guidance surgery: Computerised image-guidance operative systems provide a “road map”, similar to GPS systems, so that the surgeon is guided to all parts of the tumour, even the deepest.
  • Ultrasonic Tumour Aspirator: This surgical tool device uses ultrasound technology to fragment and liquefy tumour tissue. It then allows for the gentle suction removal of the tumour while reducing potential damage to the surrounding healthy brain or spinal cord tissue.
  • Intraoperative Neurophysiological Monitoring: Somatosensory evoked potentials, motor evoked potentials, nerve monitoring, nerve stimulation, and cortical mapping, all play a role in ensuring the safety of the operation and minimizing risk to eloquent and functional parts of the brain and spinal cord.
  • Chemotherapy Implantation: This technique involves the direct placement of chemotherapy agents into the tumour site during the surgical procedure. This approach is intended for the focused application of chemotherapy while reducing the systemic side effects.
  • Spinal Tumour Resections: This refers to the surgical removal of tumours within the spinal canal or spinal cord or its surrounding structures. The procedure is conducted with specialised microsurgical techniques to ensure the functional integrity of the spinal cord and minimise the risk of neurological deficits.
  • Radiosurgery Treatment: This includes non-invasive methods like Gamma Knife and LINAC (Linear Accelerator) radiosurgery. They involve the use of focussed radiation beams to target certain types of tumours, and not the adjacent normal tissue.

Preventative Measures

While it is not always possible to prevent brain or spinal cord tumours, certain measures can be taken to reduce its risk.

  • Regular Check-Ups: For individuals with a family history of brain or spinal cord tumours, regular medical check-ups can aid in early detection.
  • Maintaining a Healthy Lifestyle: Maintaining a healthy lifestyle, including a balanced diet, regular exercise, and avoiding tobacco and excessive alcohol, can contribute to overall health and potentially reduce cancer risk.

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Dr. Keith Goh






With more than 20 years of experience in the field of Neurosurgery, Dr Keith Goh’s subspecialty includes treatment of brain and spinal cord tumours and pediatric neurosurgery.

He is the Medical Director of International Neuro Associates, which is based at Mount Elizabeth Medical Centre, and provides specialist neurological services to all the hospitals within the Parkway Pantai hospital group. He also was Honorary Associate Professor of Neurosurgery at the Prince of Wales Hospital of the Chinese University of Hong Kong.

  • Bachelor of Medicine & Surgery — National University of Singapore
  • Neurosurgical Residency at the Chinese University of Hong Kong
  • Advanced specialty training in paediatric neurosurgery at the Beth Israel Institute of Neurology & Neurosurgery in New York

His bibliography includes 40 original articles, 11 book chapters, and 104 abstracts and lectures on his various research interests, such as brain tumours, spinal cord tumours, head trauma, conjoined twins and congenital malformations in children.


Mount Elizabeth Medical Centre,
#09-10, 3 Mount Elizabeth
Singapore 228510

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    Frequently Asked Questions

    What is the Prognosis for Brain and Spinal Cord Tumours?

    The prognosis for brain and spinal cord tumours varies based on various factors, including the type of tumour, its location, size, and whether it is benign or malignant. Early detection and treatment can improve outcomes. The effectiveness of treatment modalities, such as surgery, radiation therapy, and chemotherapy, also plays a role in the prognosis. Individuals diagnosed with these tumours should consult a neurosurgeon for guidance on appropriate courses of action suitable for their specific condition.

    What are the First Signs of Brain or Spinal Cord Tumours?

    The initial signs of brain and spinal cord tumours can vary but often include symptoms such as headaches, seizures, changes in sensory or motor functions, and alterations in cognitive abilities or personality. For spinal cord tumours, back pain, numbness, or weakness in the limbs can be early indicators. Noticing and addressing these symptoms promptly can lead to earlier diagnosis and treatment.

    What Happens if Brain and Spinal Cord Tumours Go Untreated?

    If left untreated, brain and spinal cord tumours can lead to progressive neurological deficits, impacting motor skills, sensory functions, and cognitive abilities. They can also cause serious complications like seizures and increased intracranial pressure, which could be life-threatening. Early consultation with a neurosurgeon is recommended for anyone experiencing symptoms indicative of these tumours.