Nervous System Tumors

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Signs and Symptoms
A 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) and 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. The common symptoms that patients notice are headache, nausea and vomiting, general confusion and lethargy. When the function of the brain is disrupted by localized problems associated with a tumor, symptoms include seizures, speech and language problems, visual problems, or 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. The most common symptoms of a brain tumors include particular kinds of headache, seizures (especially in adults who have never experienced seizures before), nausea and vomiting (especially when it's coupled with another symptom), a change in cognitive abilities (ability to perceive, reason and remember), and a wide range of neurological abnormalities depending on where in the brain the tumor is located.

Headaches
A new pattern or type of headache is the first noticeable symptom for about 20% of all people with brain tumors. Eventually, headaches will occur in over 60% to 70% 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 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 nonthrobbing and worse in the morning after laying 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.

Seizures
A seizure is a sudden, brief attack of uncontrolled motor activity or altered consciousness. Seizures occur in approximately 35% 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 early changes in their cognitive abilities. These include difficulties remembering things, changes in personality or mood, lack of initiative, and poor judgement. 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.

Motor and Sensory Abnormalities
The specific neurological abnormalities that a person with a brain tumor experiences vary from person to person and depend on where in the brain the tumor is located. For example, if the tumor invades the motor regions of the brain (areas responsible for movement of the skeletal muscles, such as those in the arms and legs), patients can show signs of motor weakness on the opposite side of the body (one side of the brain controls the opposite side of the body). The arms and legs on the opposite side of the body may be stiff or move awkwardly.

When the areas of the brain responsible for sensing the environment - the sensory structures - are damaged, a person may feel tingling, numbness, or other odd sensations. People may not be able to recognize parts of their environment. For example, if the tumor obstructs the visual pathways, in addition to vision loss, patients may not be able to recognize objects by looking at them. If the tumor is in the temporal lobe of the brain, a person may see hallucinations or experience other unusual perceptions. If the tumor is in the frontal lobe, a patient may have bowel and bladder problems.

Nervous System Tumors, Signs and Symptoms reprinted with permission from neurologychannel.com
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