Symptoms and diagnosis of brain tumors
A brain tumor is a mass of cells that grows over time and expands inside the brain. This expansion causes two general types of symptoms:
- Increased pressure inside the head (intracranial pressure)
- Disrupted brain function
The increased intracranial pressure can result from the growing tumor itself, swelling associated with metastatic tumors, or hydrocephalus (a swelling caused by the accumulation of too much cerebrospinal fluid) obstructing the normal flow of cerebral spinal fluid.
Common symptoms patients notice
- Nausea and vomiting
- General confusion
When the function of the brain is disrupted by localized problems associated with a tumor, symptoms include:
- Speech and language problems
- Visual problems
- General weakness
The particular symptom often reflects where in the brain the tumor is located.
The various symptoms of neurological dysfunction occur no matter how slowly or quickly the tumor grows. In slow-growing tumors, however, the brain can sometimes accommodate for the growth of the tumor, and the symptoms may be less pronounced. When the tumor grows rapidly, the symptoms may occur very suddenly and intensely.
A new pattern or type of headache is the first noticeable symptom for about 20 percent of all people with brain tumors. Eventually, headaches will occur in more than 60 percent to 70 percent of all patients at some point in the course of their illness.
The headache often is on the same side of the tumor but may be located anywhere on the head. Many headaches associated with brain tumors tend to be located on the frontal areas of the head (forehead/top of head). This happens not because the tumor is there, but rather because that is where the pain is referred (referred pain is pain that is felt somewhere different from where it originates).
Headaches caused by brain tumors are usually non-throbbing and worse in the morning after lying flat all night, because pressure in the brain increases when the head is down. They may be worse with exertion. Most patients describe nausea and vomiting with the headache. If the tumor is obstructing the ventricles, the structures that contain the cerebrospinal fluid, the headache may get worse when a person changes position.
These tumors occur in the glial cells, which help support and protect critical areas of the brain. Gliomas are the most common type of brain tumor in adults, responsible for about 42 percent of all adult brain tumors. Brain stem gliomas that are high-grade or spread widely throughout the brain stem are difficult to treat successfully. To prevent damage to healthy brain tissue, brain stem glioma is usually diagnosed without a biopsy. Gliomas are further characterized by the types of cells they affect:
A seizure is a sudden, brief attack of uncontrolled motor activity or altered consciousness. Seizures occur in approximately 35 percent of all brain tumor patients. The probability of having a seizure depends on the location of the tumor, as some parts of the brain are more prone to seizure activity than others. Some seizures may be partial and involve only a single site in the brain. Others can affect the whole brain and result in loss of consciousness.
Nausea and vomiting
When a person develops a new pattern of headaches in the morning coupled with vomiting, they should be further evaluated for the presence of a brain tumor. Even if this particular pattern doesn't develop, many people with brain tumors eventually develop chronic nausea and loss of appetite, which are presumably associated with the increased intracranial pressure (pressure within the skull compartment).
Change in cognitive status
Patients with tumors often develop changes in their cognitive abilities. These include difficulties remembering things, changes in personality or mood, lack of initiative, and poor judgment.
Depending on where the tumor is located, a person may have reading, writing or speaking difficulties. It may be very difficult for some folks to engage in abstract reasoning, and some people may not be able to make decisions. Many people with brain tumors suffer from sleep disorders and restlessness and are unable to concentrate.
Magnetic Resonance Imaging (MRI)
MRI has established itself as an important clinical tool in the diagnosis of central nervous system diseases. While MRI indications in the body are expanding, evaluation of central nervous system diseases remains the most common application of MRI today.
The complete imaging evaluation of patients with central nervous system diseases includes:
- Determination of tumor size
A biopsy is usually required to definitely diagnose a brain tumor. The physician needs to know the tumor type and grade to plan the proper treatment. A biopsy involves removing a piece of the tumor for viewing under a microscope. This is critical for an accurate diagnosis.