Pesanan Buat Suami
Oleh Dato’ Dr Hj Mohd Fadzilah Kamsah
1. Selalu menghargai usaha dan penat-lelah isteri, terutama isteri yang bekerja dan sama-sama terpaksa menanggung hutang suami.
2. Bila isteri bercakap, pandanglah mukanya dan buka telinga luas-luas. Biar apa yang dikatakannya masuk telinga kanan dan tersumbat di telinga kiri. Sambil tu otak suami kenalah memproses informasi yang diterima daripada isteri dengan bijak serta prihatin.
3. Jangan sekali-kali membandingkan masakan isteri atau cara isteri menghias rumah dengan mak anda kecuali masakan/cara menghias isteri anda lebih baik dan canggih dari emak anda..
4. Jangan demand sex sekiranya isteri tak ada mood atau letih. Agama suruh kahwin bukan semata-mata untuk penuhi nafsu syahwat saja.
5. Kalau pasangan dah ada anak, sama-samalah menjaga anak. Benih dari awak juga.. Ada suami, isteri sedang makan disuruh cebok kencing n berak anak sedangkan suami duduk tersandar kekenyangan macam maharaja.
6. Jangan sekali-kali duduk tersandar depan TV atau relax-relax sedangkan isteri bila balik dari kerja, buka saja kasut terus masuk dapur, memasak, mengemas, membasuh, kejar anak dsbnya. Berbulu mata dan sayu hati isteri bila kami tak cukup tangan nak menguruskan rumahtangga sedangkan suami lepas tangan.
7. Sekiranya suami makan dahulu, tinggalkan sedikit lauk utk isteri. Jangan bedal semua sampai turn isteri yang tinggal cuma ekor ikan sekerat, janggut sotong dan ekor taugeh.
8. Kalau nak ajak member bertandang ke rumah, beritau isteri dulu, kalau boleh sehari-dua in advance. Jadi bolehlah dia memasak yang best-best dan mengemas rumah cantik-cantik. Bayangkan perasaan isteri kalau tetamu datang terpacak sedangkan kain-baju masih berlonggok belum sempat dilipat, permainan anak masih berselerak dan isteri cuma masak mi maggi saja.
9. Jangan sekali-kali menyakat isteri tentang saiz badannya yang semakin sihat atau semakin melidi. Tengok body sendiri dalam cermin dulu.
10. Jangan kentut depan isteri. Masa bercinta dulu kenapa boleh control kentut?
11. Hormatilah ibu-bapa dan kaum keluarga isteri walaupun anda cuma main wayang, bodek mereka masa nak mengurat isteri anda dulu. Jangan sekali mencaci mereka walaupun secara bergurau.
12. Jangan kedekut dengan isteri serta keperluan rumahtangga.
13. Jagalah maruah anda sebagai suami dan lelaki. Selagi boleh, jangan bebankan isteri dengan masaalah kewangan anda. Selalunya perempuan ni, semakin suami “degil” tak nak minta pertolongan, selagi itulah dia rela nak tolong.
14. Jangan bersepah dan bersikap pengotor. Dah buka baju, letakkan dalam bakul baju kotor, dah guna cungkil gigi, buanglah dalam bakul sampah, bila dah guna ubat gigi bubuh balik penutupnya, dah ambil sesuatu barang simpan balik ditempat asal, dah berak flush. Susah sangat ke nak buat macam tu? Semua nak kena ajar ke?
15. Rajin-rajinlah bertanya isteri kalau dia perlukan bantuan anda dengan kerja rumah/menjaga anak. Tapi jangan tanya dua tahun sekali. Jangan tunjuk rajin bila ada tetamu di rumah saja.
16. Hormatilah isteri anda sebagaimana anda mahu dihormati. Isteri pun manusia. Allah berikan banyak keistimewaan kepada para isteri tapi diputar-belitkan tafsirannya oleh orang lelaki untuk kepentingan diri sendiri.
17. Jangan main kayu tiga dengan perempuan lain. Main lain lagi tak boleh. Kalau isteri awak yang buat, tentu awak tak boleh tolerate, jadi mengapa isteri awak kena tolerate kalau awak buat?
18. Kalau tak menyukai sikap atau perbuatan isteri, tegurlah secara baik, jangan asyik nak menengking aja. Kalau awak sakit nak mati nanti, siapa yang kena jaga awak? Bai jual roti? Apek jual sayur? Jiran sebelah rumah awak?
19. Kalau isteri nampak tak sihat, cepat-cepatlah bawa jumpa doktor. Tunjuklah anda mengambil berat tentang dirinya.
20. Berbincanglah dengan isteri sebelum sesuatu keputusan dibuat. Walaupun suami megah ada kuasa veto, tak jadi bapok kalau pendapat isteri diambil kira. Pokok pangkalnya ialah timbangrasa dan saling menghargai. Cubalah ketepikan ego yang keterlaluan. Bukannya laku bila dah mati nanti.
21. Dalami agama dan bimbinglah anak isteri dengan ikhlas seperti yang dituntut agama. Ingat, kalau seorang suami masuk syurga, besar kemungkinan isteri pun masuk syurga. Kalau suami masuk neraka belum tentu isteri juga masuk neraka. Kalau isteri masuk neraka, besar kemungkinan suami juga masuk NERAKA tapi kalau isteri masuk syurga belum tentu suami pun masuk syurga.Ini bukan rekaan saya tapi saya dengar dari seorang ustaz.
22. Berusahalah dengan ikhlas untuk mempertahankan keharmonian rumahtangga. Jangan buat apa yang isteri tak suka. Percayalah, kalau suami buat baik sekali dengan isteri, isteri balas sepuluh kali
23. Jangan buat donno kalau isteri merajuk atau berkecil hati. Kalau perlu minta maaf, minta maaf, kalau perlu dipujuk, pujuk. Hati orang pompuan ni sensitif. Kalau kami rasa suami tak ambil kisah, perasaan bagai dihiris-hiris. Perkara yang dipandang remeh oleh suami boleh menjadi kanser kepada isteri. Kepada para suami khususnya dan kaum lelaki amnya, janganlah dianggap masalah hati dan perasaan orang perempuan ni enteng sahaja.
Allah s.w.t. berfirman, “Dan ketahuilah bahawasanya Allah mengetahui apa yang didalam hatimu, sebab itu berhati-hatilah dengan Tuhan”
Me_Myself
Rojakzzzz info kat sini...jom usha2 apa yang ada... peace... :)
Tuesday, April 26, 2011
Monday, April 25, 2011
♥ A.Y.A.H ♥
Mungkin ibu lbh kerap menelefon utk menanyakan keadaan kita setiap hari..Tp tahukah kita, sebenar nya ayah lah yg mengingatkan ibu utk menelefon kita?
Semasa kecil, ibu lah yg lebih sering mendukung kita..Tp tahukah kita bhw sebaik saja ayah pulang bekerja dgn wajah yg letih ayahlah slalu menanyakan apa yg kita lakukan seharian ?
Saat kita sakit@demam, ayah sering membentak "sudah diberitahu! jgn minum ais!".Tp tahukah kamu bahwa ayah sangat risau.??
Ketika kita remaja, kita meminta izin untk keluar malam. Ayah dgn tegas berkata "tidak boleh!"..Sedarkah kita bhw ayah hanya ingin menjaga kita? Krn bagi ayah, kita adlh sesuatu yg sangat berharga.
Saat kita sudah d percayai, ayah pun melonggarkan peraturannya. Maka kita telah melangar kpercayaan nya...Maka ayah lah yg setia menunggu kita di ruang tamu dgn rasa sangat risau..
Setelah kita dewasa,ayah telah mghantar kita ke sekolah@kolej untuk belajar..
Di saat kita memerlukan ini-itu, utk keperluan kuliah kita, ayah hanya mengerutkan dahi.tanpa menolak, beliau memenuhinya..Saat kamu berjaya..Ayah adlh org pertama yg berdiri dan bertepuk tangan untukmu..Ayah akan tersenyum dngan bangga..
Sampai ketika jodoh kita telah datang dan meminta izin untuk mengambil kita dari ayah..Ayah sangat berhati-hati mengizinkan nya..Dan akhirnya..Saat ayah melihat kita duduk di atas plamin bersama pasangan nya..ayahpun tersenyum bahagia..
Apa kita tahu,bhw ayah sempat pergi ke belakang dan menangis?
Ayah menangis krn ayah sangat bahagia..Dan diapun berdoa "Ya Tuhan, tugasku telah selesai dgn baik..Bahagiakan lah putra putri kecilku yg manis bersama pasangannya"..
Setelah itu ayah hanya akan menunggu kedatangan kita brsma cucu-cucunya yg sesekali dtg utk menjenguk..Dengan rambut yg memutih dan badan yg tak lagi kuat untuk menjaga kita..
L ♥ ѵ ӗ U ayah ♥
Semasa kecil, ibu lah yg lebih sering mendukung kita..Tp tahukah kita bhw sebaik saja ayah pulang bekerja dgn wajah yg letih ayahlah slalu menanyakan apa yg kita lakukan seharian ?
Saat kita sakit@demam, ayah sering membentak "sudah diberitahu! jgn minum ais!".Tp tahukah kamu bahwa ayah sangat risau.??
Ketika kita remaja, kita meminta izin untk keluar malam. Ayah dgn tegas berkata "tidak boleh!"..Sedarkah kita bhw ayah hanya ingin menjaga kita? Krn bagi ayah, kita adlh sesuatu yg sangat berharga.
Saat kita sudah d percayai, ayah pun melonggarkan peraturannya. Maka kita telah melangar kpercayaan nya...Maka ayah lah yg setia menunggu kita di ruang tamu dgn rasa sangat risau..
Setelah kita dewasa,ayah telah mghantar kita ke sekolah@kolej untuk belajar..
Di saat kita memerlukan ini-itu, utk keperluan kuliah kita, ayah hanya mengerutkan dahi.tanpa menolak, beliau memenuhinya..Saat kamu berjaya..Ayah adlh org pertama yg berdiri dan bertepuk tangan untukmu..Ayah akan tersenyum dngan bangga..
Sampai ketika jodoh kita telah datang dan meminta izin untuk mengambil kita dari ayah..Ayah sangat berhati-hati mengizinkan nya..Dan akhirnya..Saat ayah melihat kita duduk di atas plamin bersama pasangan nya..ayahpun tersenyum bahagia..
Apa kita tahu,bhw ayah sempat pergi ke belakang dan menangis?
Ayah menangis krn ayah sangat bahagia..Dan diapun berdoa "Ya Tuhan, tugasku telah selesai dgn baik..Bahagiakan lah putra putri kecilku yg manis bersama pasangannya"..
Setelah itu ayah hanya akan menunggu kedatangan kita brsma cucu-cucunya yg sesekali dtg utk menjenguk..Dengan rambut yg memutih dan badan yg tak lagi kuat untuk menjaga kita..
L ♥ ѵ ӗ U ayah ♥
M.A.W.A.R.K.U
Hatiku resah,
Melihat sekuntum mawar hilang serinya,
Layunya dipetik tangan-tangan nakal,
Dikasari dengan kejam,
Adakah layaknya layanan seperti itu kepadamu?
Namun, adakah itu salah tangan-tangan yang memetikmu,
Atau dirimu terlalu mekar indah di taman,
Sehingga membangkitkan nafsu yang melihat.
Mawarku,
Tintaku tiada hentinya di sini,
Kau terlalu cantik,
Sehingga Allah menurunkan wahyu kepadamu,
An Nisa' menjadi saksi peraturan kepadamu,
Bahawa dirimu berhak dilindungi lelaki soleh.
Mawarku,
Usah kau pamerkan perhiasaanmu,
Usah kau megahkan kecantikanmu,
Kerana dirimu sememangnya perhiasaan dunia,
Setiap inci tubuhmu bakal menjadi santapan durjana,
Sekiranya kau biarkan kecantikan dirimu terdedah.
Mawarku,
Biarlah kau umpama mutiara terlindung,
Hanya dimiliki oleh insan yang ditakdirkan olehNya,
Allah itu adil dan saksama,
Walaupun kau insan lemah,
Namun imanmu jangan dibiarkan lemah.
Mawarku,
Jangan biarkan kelopakmu gugur menyembah bumi,
Lindungilah dirimu dengan shauqahmu,
Balutilah dirimu dengan sifat malu,
Jagalah akhlak dan imanmu,
Peganglah pada prinsip yang satu Innallahhama'ana..
Melihat sekuntum mawar hilang serinya,
Layunya dipetik tangan-tangan nakal,
Dikasari dengan kejam,
Adakah layaknya layanan seperti itu kepadamu?
Namun, adakah itu salah tangan-tangan yang memetikmu,
Atau dirimu terlalu mekar indah di taman,
Sehingga membangkitkan nafsu yang melihat.
Mawarku,
Tintaku tiada hentinya di sini,
Kau terlalu cantik,
Sehingga Allah menurunkan wahyu kepadamu,
An Nisa' menjadi saksi peraturan kepadamu,
Bahawa dirimu berhak dilindungi lelaki soleh.
Mawarku,
Usah kau pamerkan perhiasaanmu,
Usah kau megahkan kecantikanmu,
Kerana dirimu sememangnya perhiasaan dunia,
Setiap inci tubuhmu bakal menjadi santapan durjana,
Sekiranya kau biarkan kecantikan dirimu terdedah.
Mawarku,
Biarlah kau umpama mutiara terlindung,
Hanya dimiliki oleh insan yang ditakdirkan olehNya,
Allah itu adil dan saksama,
Walaupun kau insan lemah,
Namun imanmu jangan dibiarkan lemah.
Mawarku,
Jangan biarkan kelopakmu gugur menyembah bumi,
Lindungilah dirimu dengan shauqahmu,
Balutilah dirimu dengan sifat malu,
Jagalah akhlak dan imanmu,
Peganglah pada prinsip yang satu Innallahhama'ana..
Mengapa perempuan mudah menangis . . .
Di bawah ini hanyalah sebagai pengetahuan kepada anda sekalian untuk mengetahui kenapa perempuan mudah menangis. Supaya bagi mereka-mereka yang lelaki tahu, kenapa teman wanita mereka terlalu mudah untuk mengalirkan air mata sekiranya berlaku sesuatu dalam perhubungan.
Suatu hari, seorang anak bertanya kepada ibunya, "Ibu, mengapa ibu menangis?"
Ibunya menjawab, "Sebab ibu adalah perempuan, nak."
"Saya tidak mengerti ibu," kata si anak.
Ibunya hanya tersenyum dan memeluknya erat. "Nak, kau memang tak akan mengerti…"
Kemudian si anak bertanya kepada ayahnya. "Ayah, mengapa ibu menangis?"
"Ibumu menangis tanpa sebab yang jelas," sang ayah menjawab.
"Semua perempuan memang sering menangis tanpa alasan."
Si anak membesar menjadi remaja, dan dia tetap terus bertanya-tanya, mengapa perempuan menangis? Hingga pada suatu malam, dia bermimpi dan bertanya kepada Tuhan, "Ya Allah, mengapa perempuan mudah menangis?" Dalam mimpinya dia merasa seolah-olah mendengar
jawapannya:
"Saat Ku ciptakan wanita, Aku membuatnya menjadi sangat utama.
Kuciptakan bahunya, agar mampu menahan seluruh beban dunia dan isinya, walaupun juga bahu itu harus cukup nyaman dan lembut untuk menahan kepala bayi yang sedang tertidur.
"Kuberikan wanita kekuatan untuk dapat melahirkan bayi dari rahimnya, walau kerap berulangkali menerima cerca dari si bayi itu apabila dia telah membesar.
"Kuberikan keperkasaan yang akan membuatnya tetap bertahan, pantang menyerah saat semua orang sudah putus asa.
"Ku berikan kesabaran jiwa untuk merawat keluarganya walau dia sendiri letih, walau sakit, walau penat, tanpa berkeluh kesah.
"Kuberikan wanita perasaan peka dan kasih sayang untuk mencintai semua anaknya dalam apa jua keadaan dan situasi. Walau acapkali anak-anaknya itu melukai perasaan dan hatinya. Perasaan ini pula yang akan memberikan kehangatan pada anak- anak yang mengantuk menahan lelap. Sentuhan inilah yang akan memberikan kenyamanan saat didakap dengan lembut olehnya.
"Kuberikan wanita kekuatan untuk membimbing suaminya melalui masa-masa sukar dan menjadi pelindung baginya.
Sebab bukankah tulang rusuk yang melindungi setiap hati dan jantung agar tak terkoyak..?
"Kuberikan kepadanya kebijaksanaan dan kemampuan untuk memberikan pengertian dan menyedarkan bahawa suami yang baik adalah yang tidak pernah melukai isterinya. Walau seringkali pula kebijaksanaan itu akan menguji setiap kesetiaan yang diberikan kepada suami agar tetap berdiri sejajar, saling melengkapi dan saling menyayangi.
"Dan akhirnya, Kuberikan wanita air mata, agar dapat mencurahkan perasaannya. Inilah yang khusus kepada wanita, agar dapat dia gunakan bila-bila masa pun dia inginkan. Ini bukan kelemahan bagi wanita, kerana sebenarnya air mata ini adalah "air mata kehidupan."
Suatu hari, seorang anak bertanya kepada ibunya, "Ibu, mengapa ibu menangis?"
Ibunya menjawab, "Sebab ibu adalah perempuan, nak."
"Saya tidak mengerti ibu," kata si anak.
Ibunya hanya tersenyum dan memeluknya erat. "Nak, kau memang tak akan mengerti…"
Kemudian si anak bertanya kepada ayahnya. "Ayah, mengapa ibu menangis?"
"Ibumu menangis tanpa sebab yang jelas," sang ayah menjawab.
"Semua perempuan memang sering menangis tanpa alasan."
Si anak membesar menjadi remaja, dan dia tetap terus bertanya-tanya, mengapa perempuan menangis? Hingga pada suatu malam, dia bermimpi dan bertanya kepada Tuhan, "Ya Allah, mengapa perempuan mudah menangis?" Dalam mimpinya dia merasa seolah-olah mendengar
jawapannya:
"Saat Ku ciptakan wanita, Aku membuatnya menjadi sangat utama.
Kuciptakan bahunya, agar mampu menahan seluruh beban dunia dan isinya, walaupun juga bahu itu harus cukup nyaman dan lembut untuk menahan kepala bayi yang sedang tertidur.
"Kuberikan wanita kekuatan untuk dapat melahirkan bayi dari rahimnya, walau kerap berulangkali menerima cerca dari si bayi itu apabila dia telah membesar.
"Kuberikan keperkasaan yang akan membuatnya tetap bertahan, pantang menyerah saat semua orang sudah putus asa.
"Ku berikan kesabaran jiwa untuk merawat keluarganya walau dia sendiri letih, walau sakit, walau penat, tanpa berkeluh kesah.
"Kuberikan wanita perasaan peka dan kasih sayang untuk mencintai semua anaknya dalam apa jua keadaan dan situasi. Walau acapkali anak-anaknya itu melukai perasaan dan hatinya. Perasaan ini pula yang akan memberikan kehangatan pada anak- anak yang mengantuk menahan lelap. Sentuhan inilah yang akan memberikan kenyamanan saat didakap dengan lembut olehnya.
"Kuberikan wanita kekuatan untuk membimbing suaminya melalui masa-masa sukar dan menjadi pelindung baginya.
Sebab bukankah tulang rusuk yang melindungi setiap hati dan jantung agar tak terkoyak..?
"Kuberikan kepadanya kebijaksanaan dan kemampuan untuk memberikan pengertian dan menyedarkan bahawa suami yang baik adalah yang tidak pernah melukai isterinya. Walau seringkali pula kebijaksanaan itu akan menguji setiap kesetiaan yang diberikan kepada suami agar tetap berdiri sejajar, saling melengkapi dan saling menyayangi.
"Dan akhirnya, Kuberikan wanita air mata, agar dapat mencurahkan perasaannya. Inilah yang khusus kepada wanita, agar dapat dia gunakan bila-bila masa pun dia inginkan. Ini bukan kelemahan bagi wanita, kerana sebenarnya air mata ini adalah "air mata kehidupan."
Brain Tumor
Symptoms & Diagnosis
A brain tumor takes up space within the skull and can interfere with normal brain activity. It can increase pressure in the brain, shift the brain or push it against the skull, and/or invade and damage nerves and healthy brain tissue. The location of a brain tumor influences the type of symptoms that occur. Identifying the presence of a brain tumor is the first step in determining a course of treatment.
1. What are the symptoms of a brain tumor?
Brain tumors may have a variety of symptoms ranging from headache to stroke. Different parts of the brain control different functions, so symptoms will vary depending on the tumor's location. Brain tumors are great mimics of other neurological disorders, and many of the common symptoms could indicate other medical conditions. The best way to determine if you or someone you know has a brain tumor is to have a doctor perform a type of brain scan called an MRI or a scan called a CT scan It is sometimes hard to know whether a CT scan or MRI should be done if someone you know has some of the symptoms and signs noted below, but it is important to know that these studies will usually establish whether a brain tumor is behind them. If you are truly concerned, be sure to discuss your concerns with a physician.
Possible symptoms of a brain tumor include:
* A new seizure in an adult
* Gradual loss of movement or sensation in an arm or leg
* Unsteadiness or imbalance, especially if it is associated with headache
* Loss of vision in one or both eyes, especially if the vision loss is more peripheral
* Double vision, especially if it is associated with headache
* Hearing loss with or without dizziness
* Speech difficulty of gradual onset
Other symptoms may also include nausea or vomiting that is most severe in the morning, confusion and disorientation, and memory loss.
The following symptoms are usually not caused by a brain tumor, but may sometimes be:
* Headache: Although headaches are probably the most common symptom of a brain tumor, most people with headaches – even persistent or severe headaches – do not have a tumor. However, some kinds of headaches are particularly worrisome. A steady headache that is worse in the morning than the afternoon, a persistent headache that is associated with nausea or vomiting, or a headache accompanied by double vision, weakness, or numbness all suggest a possible tumor.
* A change in behavior: The development of an "I don't care" attitude, memory loss, loss of concentration, and general confusion may all be subtle signs. In this case, an evaluation by a neurologist may be an important step, but a CT or MRI will also help.
* Infertility or abnormal cessation of menstruation (also known as amenorrhea)
* Troubles that seem to be caused by other diseases or concerns: A seizure that results from a fall or the discovery of what appears to be a subarachnoid hemorrhage (a type of stroke) may actually be caused by tumors.
If you are concerned that you or someone you know might have a brain tumor, call your doctor. If symptoms persist, an MRI or CT scan can facilitate the diagnosis. Early detection and treatment may increase survival.
With grateful acknowledgment of the content provided by Peter McL. Black, M.D., Ph.D., Neurosurgeon-in-Chief at Brigham and Women's Hospital and Children's Hospital in Boston, Massachusetts.
2. How is a brain tumor diagnosed?
Identifying a brain tumor usually involves a neurological examination, brain scans, and/or an analysis of the brain tissue. Doctors use the diagnostic information to classify the tumor from the least aggressive (benign) to the most aggressive (malignant). In most cases, a brain tumor is named for the cell type of origin or its location in the brain. Identifying the type of tumor helps doctors determine the most appropriate course of treatment.
A neurological examination is a series of tests to measure the function of the patient s nervous system and physical and mental alertness. If responses to the exam are not normal, the doctor may order a brain scan or refer the patient to a neurologist or neurosurgeon, who will then order a brain scan.
A brain scan is a picture of the internal structures in the brain. A specialized machine takes a scan in much the same way a digital camera takes a photograph. Using computer technology, a scan compiles an image of the brain by photographing it from various angles.
Some types of scans use a contrast agent (or contrast dye), which helps the doctor see the difference between normal and abnormal brain tissue. The contrast agent is injected into a vein and flows into brain tissue. Abnormal or diseased brain tissue absorbs more dye than normal healthy tissue. The most common scans used for diagnosis are as follows:
MRI (Magnetic Resonance Imaging) is a scanning device that uses magnetic fields and computers to capture images of the brain on film. It does not use x-rays. It provides pictures from various planes, which permit doctors to create a three-dimensional image of the tumor. The MRI detects signals emitted from normal and abnormal tissue, providing clear images of most tumors.
CT or CAT Scan (Computed Tomography) combines sophisticated x-ray and computer technology. CT can show a combination of soft tissue, bone, and blood vessels. CT images can determine some types of tumors, as well as help detect swelling, bleeding, and bone and tissue calcification. Usually, iodine is the contrast agent used during a CT scan.
PET Scan (Positron Emission Tomography) provides a picture of the brain s activity, rather than its structure, by measuring the rate at which a tumor absorbs glucose (a sugar). The patient is injected with deoxyglucose that has been labeled with radioactive markers. The PET scan measures the brain s activity and sends this information to a computer, which creates a live image. Doctors use PET scans to see the difference between scar tissue, recurring tumor cells, and necrosis (cells destroyed by radiation treatment).
There some drawbacks to these diagnostic tests, however. Please refer to What else should I know about diagnostic tests? for more information.
A biopsy is a surgical procedure in which a sample of tissue is taken from the tumor site and examined under a microscope. The biopsy will provide information on types of abnormal cells present in the tumor. The purpose of a biopsy is to discover the type and grade of a tumor. A biopsy is the most accurate method of obtaining a diagnosis.
An open biopsy is done during a craniotomy. A craniotomy involves removing a piece of the skull in order to get access to the brain. After the tumor is resected (completely removed) or debulked (partially removed), the bone is usually put back into place. A closed biopsy (also called a stereotactic or needle biopsy) may be performed when the tumor is in an area of the brain that is difficult to reach. In a closed biopsy, the neurosurgeon drills a small hole into the skull and passes a narrow hollow needle into the tumor to remove a sample of tissue.
Once a sample is obtained, a pathologist examines the tissue under a microscope and writes a pathology report containing an analysis of the brain tissue. Sometimes the pathologist may not be able to make an exact diagnosis. This may be because more than one grade of tumor cells exists within the same tumor. In some cases, the tissue may be sent to another institution for additional analysis.
3. What else should I know about diagnostic tests?
Because an MRI uses magnetic fields, people who have metal implanted in their body in any form should let the doctor know about it before scheduling the procedure. An MRI may not be an option for these patients because the intense magnetic fields can damage some types of implanted medical devices. Patients should advise the doctor if they have a pacemaker, cardiac monitor, surgical clip, or facial tattoos.
In a standard MRI scan, the patient lies on a narrow table, which slides through a long, cylindrical tube with a narrow opening. Although there is enough room for the patient s body inside the cylinder, the patient will not be able to move around. The scan takes approximately 15-45 minutes. During the scan, the patient will hear loud banging sounds, caused by the electronics within the machine. Patients may request earplugs to reduce noise. Some people find the MRI claustrophobic and ask for a sedative beforehand to relax. Other people request an open MRI.
An open MRI machine does not have a cylinder, so the patient is not enclosed. The procedure lasts approximately 45 minutes. There is some discussion among doctors concerning the quality of the images of an open MRI compared to the standard or closed MRI.
Contrast agents may cause allergic reactions in some patients. Gadolinium, the contrast agent used with an MRI, may cause temporary headaches but has no other known side effects. Iodine is the contrast agent most commonly used for CT scanning. If you know you are allergic to iodine, tell your doctor. Allergic reactions can include rashes, a warm sensation, or, in rare cases, difficulty breathing.
CT scans involve exposure to ionizing radiation, which is known to cause cancer. This is a concern for people who may need multiple CT scans and for children, because they are more sensitive to radiation than adults. It is wise for people who have had frequent x-ray exams and parents of children who have brain tumors to keep a record of their x-ray history. This information can help doctors make informed decisions and minimize radiation over-exposure.
4. How is a pathology report used to diagnose brain tumors?
A pathology report contains the analysis of brain tissue taken at the time of a craniotomy or needle biopsy. A pathologist examines the tissue under a microscope. Further tests or analysis may be performed on the tumor tissue. Then the pathologist will write a pathology report, which provides the information needed to make a diagnosis of the tumor type.
Sometimes the pathologist may not be able to make an exact diagnosis. This may be because more than one grade of tumor cells exists within the same tumor. [If cells of only one grade are removed and classified during a biopsy, it is possible that the tumor grade will be misdiagnosed. This is called a sampling error.] In some cases, the tissue may be sent to another institution for additional input.
5. How can I find out more about the location and type of tumor in my brain?
The NBTS Interactive Tour of the Brain illustrates parts of the brain and their functions.
A brain tumor takes up space within the skull and can interfere with normal brain activity. It can increase pressure in the brain, shift the brain or push it against the skull, and/or invade and damage nerves and healthy brain tissue. The location of a brain tumor influences the type of symptoms that occur. Identifying the presence of a brain tumor is the first step in determining a course of treatment.
1. What are the symptoms of a brain tumor?
Brain tumors may have a variety of symptoms ranging from headache to stroke. Different parts of the brain control different functions, so symptoms will vary depending on the tumor's location. Brain tumors are great mimics of other neurological disorders, and many of the common symptoms could indicate other medical conditions. The best way to determine if you or someone you know has a brain tumor is to have a doctor perform a type of brain scan called an MRI or a scan called a CT scan It is sometimes hard to know whether a CT scan or MRI should be done if someone you know has some of the symptoms and signs noted below, but it is important to know that these studies will usually establish whether a brain tumor is behind them. If you are truly concerned, be sure to discuss your concerns with a physician.
Possible symptoms of a brain tumor include:
* A new seizure in an adult
* Gradual loss of movement or sensation in an arm or leg
* Unsteadiness or imbalance, especially if it is associated with headache
* Loss of vision in one or both eyes, especially if the vision loss is more peripheral
* Double vision, especially if it is associated with headache
* Hearing loss with or without dizziness
* Speech difficulty of gradual onset
Other symptoms may also include nausea or vomiting that is most severe in the morning, confusion and disorientation, and memory loss.
The following symptoms are usually not caused by a brain tumor, but may sometimes be:
* Headache: Although headaches are probably the most common symptom of a brain tumor, most people with headaches – even persistent or severe headaches – do not have a tumor. However, some kinds of headaches are particularly worrisome. A steady headache that is worse in the morning than the afternoon, a persistent headache that is associated with nausea or vomiting, or a headache accompanied by double vision, weakness, or numbness all suggest a possible tumor.
* A change in behavior: The development of an "I don't care" attitude, memory loss, loss of concentration, and general confusion may all be subtle signs. In this case, an evaluation by a neurologist may be an important step, but a CT or MRI will also help.
* Infertility or abnormal cessation of menstruation (also known as amenorrhea)
* Troubles that seem to be caused by other diseases or concerns: A seizure that results from a fall or the discovery of what appears to be a subarachnoid hemorrhage (a type of stroke) may actually be caused by tumors.
If you are concerned that you or someone you know might have a brain tumor, call your doctor. If symptoms persist, an MRI or CT scan can facilitate the diagnosis. Early detection and treatment may increase survival.
With grateful acknowledgment of the content provided by Peter McL. Black, M.D., Ph.D., Neurosurgeon-in-Chief at Brigham and Women's Hospital and Children's Hospital in Boston, Massachusetts.
2. How is a brain tumor diagnosed?
Identifying a brain tumor usually involves a neurological examination, brain scans, and/or an analysis of the brain tissue. Doctors use the diagnostic information to classify the tumor from the least aggressive (benign) to the most aggressive (malignant). In most cases, a brain tumor is named for the cell type of origin or its location in the brain. Identifying the type of tumor helps doctors determine the most appropriate course of treatment.
A neurological examination is a series of tests to measure the function of the patient s nervous system and physical and mental alertness. If responses to the exam are not normal, the doctor may order a brain scan or refer the patient to a neurologist or neurosurgeon, who will then order a brain scan.
A brain scan is a picture of the internal structures in the brain. A specialized machine takes a scan in much the same way a digital camera takes a photograph. Using computer technology, a scan compiles an image of the brain by photographing it from various angles.
Some types of scans use a contrast agent (or contrast dye), which helps the doctor see the difference between normal and abnormal brain tissue. The contrast agent is injected into a vein and flows into brain tissue. Abnormal or diseased brain tissue absorbs more dye than normal healthy tissue. The most common scans used for diagnosis are as follows:
MRI (Magnetic Resonance Imaging) is a scanning device that uses magnetic fields and computers to capture images of the brain on film. It does not use x-rays. It provides pictures from various planes, which permit doctors to create a three-dimensional image of the tumor. The MRI detects signals emitted from normal and abnormal tissue, providing clear images of most tumors.
CT or CAT Scan (Computed Tomography) combines sophisticated x-ray and computer technology. CT can show a combination of soft tissue, bone, and blood vessels. CT images can determine some types of tumors, as well as help detect swelling, bleeding, and bone and tissue calcification. Usually, iodine is the contrast agent used during a CT scan.
PET Scan (Positron Emission Tomography) provides a picture of the brain s activity, rather than its structure, by measuring the rate at which a tumor absorbs glucose (a sugar). The patient is injected with deoxyglucose that has been labeled with radioactive markers. The PET scan measures the brain s activity and sends this information to a computer, which creates a live image. Doctors use PET scans to see the difference between scar tissue, recurring tumor cells, and necrosis (cells destroyed by radiation treatment).
There some drawbacks to these diagnostic tests, however. Please refer to What else should I know about diagnostic tests? for more information.
A biopsy is a surgical procedure in which a sample of tissue is taken from the tumor site and examined under a microscope. The biopsy will provide information on types of abnormal cells present in the tumor. The purpose of a biopsy is to discover the type and grade of a tumor. A biopsy is the most accurate method of obtaining a diagnosis.
An open biopsy is done during a craniotomy. A craniotomy involves removing a piece of the skull in order to get access to the brain. After the tumor is resected (completely removed) or debulked (partially removed), the bone is usually put back into place. A closed biopsy (also called a stereotactic or needle biopsy) may be performed when the tumor is in an area of the brain that is difficult to reach. In a closed biopsy, the neurosurgeon drills a small hole into the skull and passes a narrow hollow needle into the tumor to remove a sample of tissue.
Once a sample is obtained, a pathologist examines the tissue under a microscope and writes a pathology report containing an analysis of the brain tissue. Sometimes the pathologist may not be able to make an exact diagnosis. This may be because more than one grade of tumor cells exists within the same tumor. In some cases, the tissue may be sent to another institution for additional analysis.
3. What else should I know about diagnostic tests?
Because an MRI uses magnetic fields, people who have metal implanted in their body in any form should let the doctor know about it before scheduling the procedure. An MRI may not be an option for these patients because the intense magnetic fields can damage some types of implanted medical devices. Patients should advise the doctor if they have a pacemaker, cardiac monitor, surgical clip, or facial tattoos.
In a standard MRI scan, the patient lies on a narrow table, which slides through a long, cylindrical tube with a narrow opening. Although there is enough room for the patient s body inside the cylinder, the patient will not be able to move around. The scan takes approximately 15-45 minutes. During the scan, the patient will hear loud banging sounds, caused by the electronics within the machine. Patients may request earplugs to reduce noise. Some people find the MRI claustrophobic and ask for a sedative beforehand to relax. Other people request an open MRI.
An open MRI machine does not have a cylinder, so the patient is not enclosed. The procedure lasts approximately 45 minutes. There is some discussion among doctors concerning the quality of the images of an open MRI compared to the standard or closed MRI.
Contrast agents may cause allergic reactions in some patients. Gadolinium, the contrast agent used with an MRI, may cause temporary headaches but has no other known side effects. Iodine is the contrast agent most commonly used for CT scanning. If you know you are allergic to iodine, tell your doctor. Allergic reactions can include rashes, a warm sensation, or, in rare cases, difficulty breathing.
CT scans involve exposure to ionizing radiation, which is known to cause cancer. This is a concern for people who may need multiple CT scans and for children, because they are more sensitive to radiation than adults. It is wise for people who have had frequent x-ray exams and parents of children who have brain tumors to keep a record of their x-ray history. This information can help doctors make informed decisions and minimize radiation over-exposure.
4. How is a pathology report used to diagnose brain tumors?
A pathology report contains the analysis of brain tissue taken at the time of a craniotomy or needle biopsy. A pathologist examines the tissue under a microscope. Further tests or analysis may be performed on the tumor tissue. Then the pathologist will write a pathology report, which provides the information needed to make a diagnosis of the tumor type.
Sometimes the pathologist may not be able to make an exact diagnosis. This may be because more than one grade of tumor cells exists within the same tumor. [If cells of only one grade are removed and classified during a biopsy, it is possible that the tumor grade will be misdiagnosed. This is called a sampling error.] In some cases, the tissue may be sent to another institution for additional input.
5. How can I find out more about the location and type of tumor in my brain?
The NBTS Interactive Tour of the Brain illustrates parts of the brain and their functions.
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