The Lobes

3 major parts:

• Cerebrum
• Cerebellum
• Brainstem (diencephalon, midbrain, pons, medulla oblongata)

Useful links:

• Lobes along with some related functions [4]
• Interactive brain view [5] and [6]
• Interactive brain view, associated functions, disorders, ... [7] and in an app (search for 3D Brain in any app store)
  
  

Fresh brain, anatomy explained. WARNING: Graphic images of human brain

The meninges - protection of the brain

image source:  [2] (left), [3] (right)

Meninges are connective tissue membranes enveloping the brain → protect brain, provide structural framework for blood vessels

Opening the dura mater induces brain shift

CSF - more protection [8,9]

Cerebrospinal fluid (CSF) acts as buffer for the brain inside the skull.

Pulsating CSF shown in MRI [8]

Location

• between arachnoid and pia mater in brain and spine
• in ventricular system (inside and around brain and spinal cord

Function

• Buoyancy
• Protection
• Decrease intracranial pressure
• Homeostasis (keep steady levels of e.g. glycine)
• Clearing waste (e.g. metabolic toxins)

Neurological exam

Assess patient's nerves, senses, muscle strength, reflexes, balance, and mental state.

Tests include: vision, hearing, reflexes, balance, sense of touch and smell, abstract thinking ability and memory.

Brain scans

With or without contrast agent possible

Anatomical imaging 

Computed Tomography (CT)

Series of x-ray images

CT of patient with glioblastoma: [11]

Magnetic Resonance Imaging (MRI)

Several very different sequences, like T1,T2, ...

T1 image with mengiome [12] and T2 image [13]

Dynamic CT or Dynamic MRI

Angiography and MRI Angiography (MRA)

Functional imaging

Magnetoencephalography (MEG)

Measures magnetic activity in the brain that is caused by neuronal activity.

Can be overlayed on top of MRI to identify functional areas in the brain.

Positron Emission Tomography (PET, FDG-PET)

Functional MRI (fMRI)

Diffusion weighted imaging (DWI) & Diffusion tensor imaging (DTI)

Single Photon Emission Computerized Tomography (SPECT)

Magnetic Resonance Spectroscopy (MRS) or Nuclear Magnetic Resonance (NMR)

Biochemical information (such as distribution of alanine in the brain)

Flow-Sensitive MRI (FS MRI)

Lab tests

Lumbar Puncture (Spinal Tap)

Collect CSF by inserting a needle into the spinal canal. Look for tumor cells, blood or proteins (infection) in the sample.

Evoked-potentials

Senses are stimulated (visual, acoustic, ...) and neuronal reaction is measured with EEG.

Audiometry

Endocrine Evaluation

Perimetry

Biomarker Research

DNA profiling

Blood test or biopsy / tissue sample (if solid tumor) to test biomarkers and find which genes are up- or down-regulated. Create personalized treatment plan that fits the profile of specific cancer.

Biopsy

Primary brain tumor

• Start in the brain and usually do not spread to other organs
• They are rather uncommon

Secondary brain tumor

• More common form
• Start in other parts of the body (often lung, breast, kidney, skin) and spread to the brain

Benign tumor

• Only contain non-cancerous cells
• Clear defined border
• Slow growth rate
• Usually do not spread
• Only operated on if symptoms occur
• Still can be deadly

Malignant tumor

• Contain cancerous cells
• varying growth rate
• sometimes spread