Some of the words found in this glossary are not found in the text of this booklet. They are included here as they may be associated with the care of a brain tumour patient.

Acromegaly: This is a condition caused by excess growth hormone (GH) by the pituitary gland usually due to a pituitary adenoma. Untreated, this condition can cause bone and soft tissue changes, enlargement of the hands and feet, and sleep apnea. More serious conditions such as cardiovascular disease and hypertension can also result from this condition.

Anesthesia: The administration of medications, both intravenous and gaseous, to provide pain relief and/or unconsciousness during surgery. Anesthesia can be general (the patient is asleep and unaware of surroundings), local (the patient is awake and aware but feels no pain), or neuroleptic (the patient is given medications to make him drowsy and diminish memory and awareness but is not actually asleep).

Anesthesiologist: A physician who has specialized in the administration of anaesthesia and in the care of patients before, during, and after anaesthesia.

Analgesic: A medication administered to reduce pain.

Angiogenesis: The growth of new blood vessels. This is an important natural process occurring in the body, both in health and in disease.

Angiogram: An angiogram is the most effective means available of studying the blood vessels of the brain. Any abnormalities present will become evident. The test is performed by a neuroradiologist. The procedure takes place in the X-ray department. Sedation is usually given before the procedure begins. Through a catheter, periodic injections of a contrast agent ("dye") are made. The dye makes the X-ray images clearer and easier to read. X-rays are taken during the dye injections.

Anti-angiogenesis: A therapy to halt the growth of new blood vessels that bring nutrients to the tumour cells.

Anticonvulsants: Medications used to treat seizures.

Antiemetics: Medications used to treat nausea and vomiting.

Ataxia: Inability to coordinate movements and maintain posture; a tendency to lose balance.

Benign: Slow-growing, non-malignant tumour that does not spread to other parts of the body. If completely removed, benign lesions do not tend to recur. Incompletely removed tumours may recur but will not spread.

Biopsy: The removal of a small portion of a tumour to allow a pathologist to examine it under a microscope and provide a diagnosis of tumour type.

Blood Brain Barrier: A group of mechanisms associated with the brain vessel wall which control the movement of drugs and chemicals into the brain. The Blood Brain Barrier may be disrupted in brain tumours and is the basis for the enhanced CT and MRI Scan.

Cells: The body is made up of tiny, functioning units called cells. These can be observed under a microscope. Each cell plays a specialized role in the body. Groups of cells are organized together to form tissue. Tissues are organized to form organs in the body, e.g. our heart has very specialized cells that work together, causing our heart to beat and pump blood to other regions of the body.

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: The term chemotherapy is commonly used to describe the drugs used to treat cancer. Depending on the type of tumour, 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.

Chromosomes: Chromosomes are paired segments of DNA contained within the nucleus of each cell. In humans, there are 23 pairs of chromosomes.

Clinical Trial: Clinical trials are the final steps in the long process of bringing new treatments to patients. Promising new treatment ideas are tested extensively in laboratories on brain tumour samples and in animals. In a phase I clinical trial those treatments that appear best are tested for the first time in people who have brain tumours; the purpose of a phase I trial is to see if giving the treatment is safe. In a phase II trial, safe treatments from phase I are tested to see if they can shrink tumours and prolong life. In a phase III trial those safe and seemingly effective treatments from phase II are tested in a much larger number of patients and are usually compared to what is considered to be the best treatment currently available.

CNS / Central Nervous System: Referring to the brain, spinal cord, and the cranial nerves.

Cognition: A generic term involving perceiving, recognizing, conceiving, judging, sensing, reasoning, remembering and imagining.

Congenital: Existing before or at birth.

Corticosteroids: Drugs used to decrease swelling (edema) around tumours.

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 tumours 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 tumour 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.

Diabetes Insipidus: Diabetes insipidus is caused by the inability of the kidneys to conserve water, which leads to frequent urination and pronounced thirst.

Diplopia: Double vision.

Dura Mater: The outer membrane covering the brain.

Edema: An excessive amount of fluid within the brain tissue, which is not related to an increased amount of cerebrospinal fluid. Brain tumours may affect the blood vessels in their vicinity allowing extra fluid to seep into normal brain tissue. Steroids such as Decadron are commonly used to treat edema.

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.

Enhancement: After the injection of contrast material for CT or MRI, in specific tumours, because of an abnormality in the vessels that nourish them, the contrast material crosses this abnormal blood-brain barrier and outlines the tumour more clearly.

Epilepsy: Epilepsy is a physical condition characterized by sudden, brief changes in how the brain works. It is a symptom of a neurological disorder - a disorder that affects the brain and shows itself in the form of seizures.

Fatigue: A common side effect experienced by many patients as a direct result of the tumour, swelling, and/or treatment. Enough rest, proper nutrition, and moderate exercise can all help to combat this symptom.

Gastronomy (G-tube): A tube inserted into the stomach for feeding purposes if swallowing is a problem.

Gene: A gene contains hereditary information encoded in the form of DNA and is located at a specific position on a chromosome in a cell's nucleus. Genes determine many aspects of anatomy and physiology by controlling the production of proteins. Each individual has a unique sequence of genes, or genetic code.

Grade: Brain tumours are often given a grade from 1 through 4 (I - IV). A grade 1 is given to the most benign tumours, and this increases to a grade 4, which is given to the most malignant tumours.

Gross Total Resection (GTR): No evidence of residual or remaining tumour on post-operative scans.

Health Care Professional: Any medical team member involved in your care. e.g. 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.

Hospice: A program that provides comfort and supportive care for terminally ill patients and their families, either directly or on a consulting basis with the patient's physician or another community agency. The whole family is considered the unit of care, and care extends through their period of mourning.

Hydrocephalus: Often referred to as "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 and the CSF may accumulate causing intracranial pressure.

Immune System: The body's natural defence system that protects it from foreign substances such as bacteria and viruses, which may be harmful to the body.

Incidence: The number of new instances of a specific condition occurring during a certain period in a specified population.

Increased Intracranial Pressure: Increased pressure within the brain. This can be caused by the brain tumour and/or edema (swelling) in the surrounding brain tissue.

Infiltrating: When a tumour penetrates normal tissue, it is often referred to as infiltrating.

Intravenous: A method of giving medicine, fluids or nutrition through a needle, small tube, or butterfly placed directly in a vein.

Lesion: A general term that refers to any change in tissue such as a tumour, blood, malformation, infection, or scar tissue.

Linear Accelerator: A machine used to deliver high-energy radiation beams to a targeted tumour site.

Lumbar Puncture (LP:) Also known as a Spinal Tap. This is a procedure that draws cerebrospinal fluid 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. A needle, into which the clear fluid will drain, is 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. Mild analgesics and sedatives may be given prior to the procedure.

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