Pregnancy is usually a time filled with happiness and hope, plans for the new addition to the family, and pampering. But for some expecting moms, that journey can be jolted by an unexpected and infrequent diagnosis — one of a brain tumour.

Pregnancy already brings significant physical changes, emotional ups and downs, and constant monitoring of health. The presence of a brain tumour during this time turns the situation into one of the most complex medical scenarios a person can face. Two lives are at stake in such cases, and every decision must be made with caution, deliberation, and careful consideration.

Diagnosis and Initial Assessment

Identifying a brain tumour diagnosis in a pregnant woman is particularly challenging because many of the symptoms of brain tumours usually share common physiological changes and discomforts associated with pregnancy. Nausea, vomiting, persistent headaches, and dizziness are common during pregnancy, but they are also key warning signals of a brain tumour.

This overlap often leads to misdiagnosis or delay in diagnosis, as medical professionals may initially attribute the symptoms to pregnancy-related discomfort. When these symptoms persist or worsen, imaging is used to confirm the diagnosis.

Magnetic Resonance Imaging (MRI)is the preferred method, as it provides detailed images without radiation and is considered safe during pregnancy. In some cases, additional tests or a biopsy may be required if the type of tumour is unclear.

Computed Tomography (CT) scans are generally avoided during pregnancy as they use ionising radiation, which is a risk to the foetus.

Diagnosis of brain tumours during pregnancy is typically established through a multidisciplinary approach involving obstetricians, neurologists, and radiologists. Once the type of tumour is confirmed, the medical team considers several key questions:

1. Is it a low-grade or a high-grade tumour?
2.  Is it causing pressure on the brain?
3.  How far along is the pregnancy?

Tumours that are slow growing, such as meningiomas, may be monitored closely until it is safe to give treatment (particularly either in the second trimester or after delivery). More aggressive tumours like glioblastomas may require immediate action, even in early pregnancy.

Impact of Pregnancy on Tumours

Pregnancy causes major physiological changes in a woman, including increased levels of hormones like oestrogen and a rise in blood volume. These changes can, in some cases, accelerate the growth of the tumour.

Treatment Considerations

Treatment of brain tumours in pregnancy requires a multidisciplinary approach that carefully considers the safety and health of both the mother and the foetus. Treatment plans are highly individualised and depend on several factors, including the type and location of the tumour, its rate of growth, the patient’s symptoms, and the stage of pregnancy.

Surgery is often recommended if the tumour is causing increasing intracranial pressure, bleeding, or severe symptoms. The second trimester is considered to be the safest period for a surgery, as the risk to the foetus is lower than in the first trimester and the uterus is not yet large enough to complicate things.

If the patient is in the third trimester, doctors may consider scheduling an early delivery (typically between 32 to 36 weeks) so that surgery or additional treatment can begin promptly afterward.

Chemotherapy and radiation therapy are typically delayed until after delivery unless the situation is urgent. Some chemotherapy agents may be used during the second or third trimester with caution, but they are usually avoided in the first trimester due to the high risk of birth defects.

Delivery Considerations

Delivery planning in this context involves careful coordination among obstetricians, neurosurgeons, and anaesthesiologists. When and how to schedule the delivery depends on several factors:

Timing

• If the tumour is stable and not causing significant symptoms, delivery may proceed at full term (around 39 to 40 weeks).
• If the tumour is aggressive or the mother’s condition is worsening, an early delivery (32 to 36 weeks) may be recommended to allow prompt treatment.
• In the case of a medical emergency, such as seizures or brain swelling, an emergency delivery may be performed at any gestational age to protect the mother’s life.

Mode of delivery

• If the tumour affects the mother’s ability to safely go through labour—for example, due to increased intracranial pressure—then a C-section is usually recommended to minimise the risk of complications during delivery.
• If the tumour is small and not causing pressure-related symptoms, vaginal delivery may still be an option.

Psychological considerations

A brain tumour diagnosis is inherently a life-changing and traumatic event. When it occurs during pregnancy, it introduces an additional layer of emotional and psychological distress. This can impact the overall well-being of the patient.

Patients commonly experience:

• Heightened anxiety
• Depression
• Guilt or fear about the baby’s future
• Emotional isolation

Recognising and addressing these emotional needs is essential. Mental health support—through counselling, support groups, or psychiatric care—should be an integral part of treatment.

Conclusion

A brain tumour diagnosis during pregnancy presents one of the most complex, rare, and emotionally challenging medical scenarios. It requires highly individualised care, constant re-evaluation, and a coordinated effort across multiple specialities.

With thoughtful planning and compassionate support, it is possible to protect the health of both the mother and the baby. The path may be difficult, but patients do not have to face it alone; with the right care, there is hope for a safe outcome.

The post How to Cope with a Brain Tumour While Expecting a Child appeared first on NRI News.

By Dr. Sathyanarayana L.D, Consultant Neurosurgeon, Narayana Health, Bengaluru.

A common but neglected complication

Language is central to how we think, relate, and exist in the world. Speech involves the ability to use movements of the tongue, lips, jaw muscles, and vocal tract to produce sounds. Aphasia (sometimes called dysphasia) is a broad-spectrum acquired language disorder affecting a person’s ability to process, use, and/or understand language. It can affect all forms of language – speaking, listening, reading, and writing. Aphasia can cause frustration and stress for an individual living with it, as well as for their caregiver. Research indicates that about 30 percent of patients who undergo brain tumor surgery in the language-dominant hemisphere (typically the left side) develop some form of aphasia. Yet, despite its prevalence and impact, aphasia remains an under-addressed concern in post-operative care across India.

Aphasia can vary from mild degree wherein there is trouble understanding long messages and needing a little extra time to understand and respond to spoken messages and difficulty finding words to express or explain an idea to severe degree in which there is little to no ability to speak, read or write or using a combination of words and jargon that is not understood by others and being unaware of own errors.

Location of the tumour

Whether and how a brain tumor affects a person depends on where it is in the brain. Each section or lobe of the brain is responsible for different functions, some of which are involved in communication. For example, the frontal lobe is involved in language production (how we express ourselves), and the temporal lobe is involved in understanding what others are saying to us and how our thought processes work. As a result, pressure from a tumor in one of these areas of the brain can affect the ability to speak and understand what others are saying. Areas of the brain controlling language are generally found in the left hemisphere, so if this is where the tumor is, a person is more likely to experience language and speech difficulties.

However, in some cases speech centre is found in the right hemisphere, for instance, especially with left-handed people. Because our brains are responsible for controlling the muscles needed to produce speech, a brain tumor can also cause difficulty speaking by interrupting some signals being sent to the mouth, dysarthria. Brain tumors can either be benign (non-cancerous) or malignant (cancerous). A tumor can cause aphasia if it impacts the brain’s language centers. Aphasia due to cancer is called neoplastic aphasia.

The most common type of aphasia due to a brain tumor is anomic aphasia. Aphasia due to brain tumors is more likely to be short-term and milder than post-stroke aphasia. The outcome and prognosis for cancer-related aphasia are also dependent on the success of the medical treatment. If the tumor is treated successfully, the aphasia is likely to resolve.

Types of aphasia:

• Expressive aphasia: Difficulty speaking or finding the right words
• Receptive aphasia: Difficulty understanding spoken language or written words
• Global aphasia: A severe form of aphasia affecting both speech production and language comprehension

Why Early Therapy Matters

Slow-growing brain tumors in the left cerebral hemisphere can impact the brain. For patients recovering from brain tumour surgery, this vital faculty is sometimes the most painful loss. Timely and individualized speech therapy plays a critical role in helping the brain reorganize and compensate for lost function — a process known as neuroplasticity. This could mean that if the tumor is impacting a language center, the brain can shift language processing to another part of the brain. The first three to six months after surgery are a golden window for recovery.  There are dozens of ways that speech-language pathologists (SLPs) treat aphasia. The type of treatment a person receives is generally determined by the type of aphasia he or she has, as well as the severity of it. However, it can also be guided by the needs of individual patients and their families as it relates to activities of daily living.

What can be done

• Integrate speech therapy into standard post-operative protocols
• Strengthen the workforce and training
• Harness teletherapy and digital health tools
• Support families and caregivers
• Include rehabilitation under insurance and public health schemes

Giving Voice to Recovery

Aphasia doesn’t kill, but it can erase identity, self-worth, and connection. In a society where verbal communication dominates, losing language means losing participation. Yet, with appropriate therapy and support, many patients make remarkable recoveries. The challenge is not healthcare possibility, but access and awareness.

The time has come to treat rehabilitation as essential, not optional. In India’s expanding neurosurgical landscape, we cannot afford to let patients survive surgery only to live in silence. They deserve more than survival; they deserve to be heard. I advocate a multidisciplinary, integrated approach to neuro-rehabilitation and particularly speech therapy. Speech-language therapy is to be initiated during inpatient recovery for at-risk patients and continued via outpatient or tele-rehabilitation pathways.

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GURUGRAM: Fortis Memorial Research Institute proudly announces the launch of the South Asia’s First Gamma Knife Esprit. This groundbreaking version of the Leksell Gamma Knife® heralds a new era in the non-surgical high precision treatment of brain tumours, greatly enhancing therapeutic options for both malignant, benign brain tumours and other abnormalities of Brain.

The Gamma Knife employs computer-guided precision to target brain tumours without actual cutting, making it an optimal choice for treating both malignant and benign tumours, including multiple brain metastases, meningiomas, acoustic tumours, and pituitary adenomas. Its precision is crucial for tumours in sensitive or hard-to-reach brain areas with sparing healthy brain tissues and allows patients to return to daily activities almost immediately. Further, radiation therapy for multiple brain metastasis requires almost 30 sessions, in contrast, Gamma Knife radiosurgery consolidates the entire treatment into a single session with same day discharge, making the treatment swift and efficient. Additionally, Gamma Knife can treat multiple metastasis in a single session irrespective of metastatic lesions involved, a benefit not offered by other technologies. This method significantly minimizes radiation exposure to healthy tissues, preserving motor, sensory nerve and neurocognitive function enabling rapid recovery and improved healthy quality of life after treatment. Thus, Gamma Knife radiosurgery is considered as the gold standard for brain radiosurgery worldwide. The procedure can be performed using either frame-based or frameless methods, for personalized care for the patients with comfortable treatment experience and is followed by stereotactic MRI to ensure precise treatment delivery.

Fortis Healthcare has introduced Gamma Knife technology, a time-tested, reliable method with extensive clinical validation and high confidence among clinicians and patients across India and worldwide. This integrated and efficient system boasts a guaranteed accuracy of 0.3 mm, delivering doses to healthy brain tissue that are 2–4x lower than other technologies, with 2–21x lower extracranial doses. This highest accuracy and precision in Gamma knife reduces toxicities and side effects to normal brain. Gamma Knife ensures high success rate for controlling brain tumours and other brain conditions with minimal side effects. Gamma Knife radiosurgery boasts an impressive track record with a control rate surpassing 95% over a span of 10 years, providing reassuring long-term relief.

Dr. Sandeep Vaishya, Director Neurosurgery, Fortis Gurgaon, said “The launch of South Asia’s first Gamma Knife Esprit at our facility marks a significant milestone in the field of neurosurgery. This advanced technology brings a level of precision to neurosurgical procedures that was previously unattainable, targeting brain tumours with pinpoint accuracy. The Gamma Knife Esprit minimizes the radiation exposure to healthy tissues which is crucial for reducing potential side effects. This capability allows us to enhance patient safety and comfort significantly, thus optimizing the recovery process. By drastically cutting down recovery times, we are not only improving clinical outcomes but also enhancing the overall patient experience. This is a step forward in our ongoing effort to push the boundaries of what’s possible in medical treatment and patient care.”

Anil Vinayak, Group COO, Fortis Healthcare, elaborated on the broader vision of Fortis as a leader in comprehensive cancer care: “Deploying the first Gamma Knife Esprit in South Asia is a testament to Fortis Healthcare’s commitment in integrating cutting-edge technologies in neurosurgery and holistic cancer care. Our commitment extends beyond just offering advanced treatments; it encompasses providing comprehensive care that enhances the overall patient journey and outcomes. This initiative is another step in reinforcing our position at the forefront of medical innovation and patient-centric care across the region.”

Jan Thesleff, Amabassador of Sweden to India, who is the Chief Guest at the inauguration, said, “As the Chief Guest at the launch of the most advanced Gamma Knife Esprit at Fortis Memorial Research Institute (FMRI) in Gurgaon, I am deeply honoured to witness the pioneering collaboration between Swedish companies like Elekta and India’s leading healthcare chain, Fortis Healthcare. This landmark introduction of precision radiosurgery technology, the first of its kind in South Asia, underscores the transformative impact of our partnership and FMRI’s dedication to advancing healthcare excellence. Swedish companies are renowned for their leadership in healthcare innovation, and through initiatives like this, we are collectively bridging gaps in advanced medical treatments, ensuring patients in the region have access to cutting-edge care. Our continued collaboration between Sweden and India, particularly with Fortis Healthcare, is a testament to our shared commitment to innovation and excellence in healthcare. I eagerly anticipate the continued success of our partnerships and the delivery of sustainable healthcare solutions for all.”

The Department of Neurosurgery at Fortis Memorial Research Institute, Gurugram offers a comprehensive range of services for the prevention, diagnosis, and treatment of disorders affecting the brain, spine, and peripheral nerves. These services include a wide spectrum of brain surgeries, ranging from intracranial tumours, skull base surgery, and deep brain stimulation surgery to brain aneurysm and AVMs (endovascular/surgery), epilepsy surgery, head injury, stroke, endoscopic surgery, and hydrocephalus surgery.  Additionally, the department provides various spine surgeries, including cervical and lumbar disc surgeries, degenerative spine surgeries, surgeries for spine tumours, spinal tuberculosis, spinal injuries, and fractures. These procedures are performed using image guidance and intraoperative imaging, with many surgeries conducted through keyhole incisions. The department boasts a dedicated and highly qualified team of neurosurgeons, neuro-anaesthetists, intensive care specialists, and related technical support staff.

Equipped with the latest technology and equipment, the department ensures successful procedures and promotes speedy recovery with minimal discomfort for patients. The addition of Gamma Knife technology reaffirms Fortis’s commitment to leading innovations that revolutionise lives.

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