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Brain tumors - primary - Symptoms

Description

An in-depth report on the causes, diagnosis, and treatment of brain tumors.

Alternative Names

Gliomas; Medulloblastomas

Symptoms:

Brain tumors produce a variety of symptoms, ranging from headache to seizure. They are great mimics of other neurologic disorders. Symptoms occur if the tumor directly damages the nerves in the brain or central nervous system or if its growth imposes pressure on the brain. Symptoms may be subtle and gradually become worse or they may occur very rapidly.

Headache

Headache is probably the most common symptom of a brain tumor. However, headaches are very common and the vast majority are not caused by brain tumors. [For more information on headaches, see In-Depth Reports #97: Migraine headache; #11: Tension headache; and #99: Cluster headache.]

Headaches caused by brain tumors vary depending on the location, and many other factors. Headache symptoms associated with brain tumors may include:

  • Steady and worse upon waking in the morning and clears up within a few hours
  • Persistent non-migraine headache that occurs while sleeping and is also accompanied by at least one other symptom (such as vomiting or confusion)
  • May or may not be throbbing, depending on location of the tumor
  • Accompanied by double vision, weakness, or numbness
  • May worsen with coughing or exercise or with a change in body position
  • Sometimes accompanied by neck pain

Gastrointestinal Symptoms

Gastrointestinal symptoms, including nausea and vomiting, are also common.

Seizures

About half of patients with brain tumors experience a seizure. It is a common presenting symptom of brain tumors in older adults. (However, fewer than 10% of first seizures are caused by a brain tumor.)

  • Tumors are more likely to be localized and affect one area of the brain. In such cases they can cause partial seizures. In this case, a person does not lose consciousness but may experience confusion, jerking movements, tingling, or odd mental and emotional events.
  • Generalized seizures, which can cause loss of consciousness, are less common, since they are caused by disturbances of nerve cells in diffuse areas of the brain.

Mental Changes

Sometimes the only symptoms of brain tumors are mental changes, which may include:

  • Memory loss
  • Impaired concentration
  • Problems with reasoning
  • Changes in personality and behavior
  • Increased sleep

Other Significant Symptoms

  • Gradual loss of movement or sensation in an arm or leg
  • Unsteadiness and problems with balance
  • Unexpected visual disturbance (especially if it is associated with headache), including vision loss (usually of peripheral vision) in one or both eyes or double vision
  • Hearing loss with or without dizziness
  • Speech difficulty

Resources

References

Bowers DC, Liu Y, Leisenring W, McNeil E, Stovall M, Gurney JG, et al. Late-occurring stroke among long-term survivors of childhood leukemia and brain tumors: a report from the Childhood Cancer Survivor Study. J Clin Oncol. 2006 Nov 20;24(33):5277-82. Epub 2006 Nov 6.

Buckner JC, Brown PD, O'Neill BP, Meyer FB, Wetmore CJ, Uhm JH. Central nervous system tumors. Mayo Clin Proc. 2007 Oct;82(10):1271-86.

Chandana SR, Movva S, Arora M, Singh T. Primary brain tumors in adults. Am Fam Physician. 2008 May 15;77(10):1423-30.

Krex D, Klink B, Hartmann C, von Deimling A, Pietsch T, Simon M, et al. Long-term survival with glioblastoma multiforme. Brain. 2007 Oct;130(Pt 10):2596-606. Epub 2007 Sep 4.

Nathan PC, Patel SK, Dilley K, Goldsby R, Harvey J, Jacobsen C, et al. Guidelines for identification of, advocacy for, and intervention in neurocognitive problems in survivors of childhood cancer: a report from the Children's Oncology Group. Arch Pediatr Adolesc Med. 2007 Aug;161(8):798-806.

National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Central nervous system cancers. V.1.2008

Neglia JP, Robison LL, Stovall M, Liu Y, Packer RJ, Hammond S, et al. New primary neoplasms of the central nervous system in survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. J Natl Cancer Inst. 2006 Nov 1;98(21):1528-37.

Norden AD, Young GS, Setayesh K, Muzikansky A, Klufas R, Ross GL, et al.Bevacizumab for recurrent malignant gliomas: efficacy, toxicity, and patterns of recurrence. Neurology. 2008 Mar 4;70(10):779-87.

Sathornsumetee S, Reardon DA, Desjardins A, Quinn JA, Vredenburgh JJ, Rich JN. Molecularly targeted therapy for malignant glioma. Cancer. 2007 Jul 1;110(1):13-24.

Wen PY, Kesari S. Malignant gliomas in adults. N Engl J Med. 2008 Jul 31;359(5):492-507.

  • Reviewed last on: 12/5/2008
  • Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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