Tuesday, February 1, 2011

Brain Tumor Symptoms


Symptoms

Just as you are a unique individual, each brain tumor is unique. In this article, we hope to help you understand some of the more common symptoms of a brain tumor. Think of the brain as the computer center for your body; each part of the brain controls a different function of your body. Symptoms depend on where within the brain the tumor is located. But be aware -- the symptoms produced by a brain tumor often mimic the symptoms of other diseases.

General Symptoms of a Brain Tumor
HeadachesHeadaches are a common initial symptom. Typical "brain tumor headaches" are often described as worse in the morning, with improvement gradually during the day. They may rouse the person from sleep. Sometimes, upon awakening, the person vomits then feels better. These headaches may worsen with coughing, exercise, or with a change in position such as bending or kneeling. They also do not typically respond to the usual headache remedies.

There are many causes, and types, of headaches. If you are experiencing headaches, we encourage to talk to your doctor. He or she is best able to listen to your concerns, outline your medical and headache history, and determine the next "best step" in your care. Don't know where to start? A visit to your family physician, internist, or primary care provider is a good beginning. If you need or wish specialty care, "neurologists" are doctors trained in the workings of the brain, spine, and nerves. If specialty care is your preference, your family doctor can help you locate a neurologist who specializes in headaches.

To help your doctor better understand your symptoms, prepare for your visit in advance. Keeping a "headache journal"- when they occur, how severe they are, other symptoms that happen at the same time, and the type of remedies you try in an attempt to relieve your symptoms - will provide the doctor with a good overview of the nature of your headaches. Tell your doctor about any changes in your vision, nausea or vomiting, and the severity of those symptoms. After learning your concerns and asking specific questions about your symptoms, your doctor will determine the next step in finding the cause of your headaches.   

There are several sources for additional information about headaches:

The Headache Information Page of the National Institute of Neurologic Disorders  

The National Headache Foundation

National Library of Medicine MedLine Plus Section on Headaches

Merck Manual Home Edition Online
Other Symptoms of a Brain Tumor:
Seizures
About one-third of people diagnosed with a brain tumor are not aware they have a tumor until they have a seizure. Seizures are a common symptom of a brain tumor. Seizures are caused by a disruption in the normal flow of electricity in the brain. Those sudden bursts of electricity may cause convulsions, unusual sensations, and loss of consciousness. Focal seizures -- such as muscle twitching or jerking of an arm or leg, abnormal smells or tastes, problems with speech or numbness and tingling -- may also occur.
Mental and/or Personality Changes
These can range from problems with memory (especially short-term memory), speech, communication and/or concentration changes to severe intellectual problems and confusion. Changes in behavior, temperament and personality may also occur, depending where the tumor is located. These changes can be caused by the tumor itself, by increased pressure within the skull caused by the presence of the tumor, or by involvement of the parts of the brain that control personality.
Mass effect
Mass effect is due to increased intracranial pressure, also called IICP. This increased pressure in the brain may be caused by a tumor growing within the tight confines of the skull, or by hydrocephalus - the blockage of the fluid that flows around and through the brain, and/or by edema - swelling of the brain around the tumor due to an accumulation of fluid. Mass effect can cause damage by compressing and displacing the delicate brain tissue. The symptoms caused by IICP include nausea and vomiting, drowsiness, vision problems such as blurred or double vision or loss of peripheral vision, and the headaches and mental changes already mentioned. A swollen optic nerve (papilledema) is a clear sign of IICP. It can be observed by your eye doctor when he examines your eyes. This sign is common in young children, in persons with slow growing tumors, with tumors in the posterior fossa, and in older patients.
As IICP increases, prompt treatment is required to avoid serious consequences. If you or your loved one is experiencing vision changes, severe/sudden-onset personality changes, vomiting, or severe head pains, please seek emergency medical assistance. This web site, and/or the ABTA staff, do not provide medical advice.
Focal, or Localized, Symptoms
In addition to the common, but non-specific symptoms listed above, other more specific symptoms frequently occur. These "focal symptoms" can help identify the location of the tumor. Focal symptoms include: hearing problems such as ringing or buzzing sounds or hearing loss, decreased muscle control, lack of coordination, decreased sensation, weakness or paralysis, difficulty with walking or speech, balance problems, or double vision. 
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Click here to learn how brain tumors are diagnosed 


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How do you know if you have a brain tumor? If you are concerned about any symptoms you are experiencing, or anything you read here, we encourage you to consult your doctor. Share your concerns. The listed symptoms can have many different causes; your doctor can listen to your medical history and make suggestions to help find the cause for your symptoms.
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Symptoms by Tumor Location
The following, more specific symptoms are due to a tumor's effect on specific brain structures. Because the tracts of the central nervous system cross near the base of the skull, a tumor on the right side of the brain may cause symptoms on the left side of the body, and vice-versa, depending on the specific brain structure affected.
Brain Stem - the Midbrain, Pons, Medulla OblongataThe brain stem controls basic life functions including blood pressure, heart beat, and breathing. The reticular formation (the central core of the brain stem) controls consciousness, eating and sleeping patterns, drowsiness and attention. A tumor of the brain stem produces a variety of symptoms. The most common symptoms are vomiting (usually just after awakening), and a clumsy, uncoordinated walk. Muscle weakness on one side of the face causes a one-sided smile or drooping eyelid. Difficulty in swallowing and slurred or nasal speech are also common. In addition, double vision with an inability to fully move one or both eyes might occur. Headache, usually just after awakening, is common. Head tilt, drowsiness, hearing loss and/or personality changes can also be present. Symptoms may develop gradually.
Cerebellum
Located in the posterior fossa, the cerebellum together with the thalamus and cerebrum controls intricate muscular coordination, including walking and speech. See Posterior Fossa.
Cerebellopontine AngleThe earliest symptom of a tumor in this location is ringing or buzzing in the ear. Less often, dizziness might occur. As a tumor grows, deafness, loss of facial sensation and/or facial weakness can occur. Other symptoms are similar to those of a brain stem tumor.
Cerebral Hemispheres
The "cerebral hemispheres" are the two large, upper sections of the brain. Each cerebral hemisphere is divided into four sections, or lobes.
    Frontal Lobe The frontal lobe of each hemisphere controls voluntary movement, usually on the opposite side of the body. The frontal lobe of the dominant hemisphere controls language and writing. (The dominant hemisphere is the left hemisphere in all right-handed and some left-handed individuals, and the right hemisphere in most left-handed people.) Other frontal lobe activities include intellectual functioning, thought processes, behavior, and memory.
    Tumors in the frontal lobe may initially be "silent." As they grow, they can cause a variety of symptoms including one-sided paralysis, seizures, short-term memory loss, impaired judgment and personality or mental changes. Urinary frequency and urgency can develop. Gait disturbances and communication problems are also common. If the tumor is at the base of the frontal lobe, loss of smell, impaired vision, and a swollen optic nerve can occur.
    Occipital Lobe The occipital lobe is involved in the understanding of visual images and the meaning of written word. Blindness in one direction or other visual disturbances, and seizures are common symptoms.
    Parietal Lobe The parietal lobe receives and interprets sensations including pain, temperature, touch, pressure, size, shape, and body-part awareness. Other activities of the parietal lobe are hearing, reasoning and memory. Seizures, language disturbances (if a tumor is in the dominant hemisphere) and loss of ability to read are common symptoms. Spatial disorders, such as difficulty with body orientation in space or recognition of body parts, can also occur. The parietal lobe also controls language and the ability to do arithmetic. Numbers may be read, but there may be difficulty with calculations. There may be difficulty knowing left from right and sentences containing comparisons or cross-references may not be understood.
    Temporal Lobe The temporal lobe is involved in the understanding of sounds and spoken words, as well as emotion and memory. Depth perception and the sense of time are also controlled by the temporal lobe. Seizures are the most common symptom of a tumor in this location. The ability to recognize sounds or the source of sounds may be affected. Vision can be impaired.
Basal GangliaOne-sided paralysis is the most common symptom. This tumor might invade other areas of the cerebral hemispheres and produce symptoms common to tumors in those locations. Seizures are uncommon.
Corpus Callosum
Impaired judgment and defective memory are frequent symptoms of a tumor in the forward part of this area; behavioral changes are common with a tumor in the rear part. A tumor in the middle of the corpus callosum might cause few, if any, symptoms until it grows quite large. This tumor might invade other lobes of the cerebral hemispheres and produce symptoms common to tumors in those locations. Seizures are uncommon.
Hypothalamus
The hypothalamus controls thirst and urination, sleep, body temperature, appetite, and blood pressure. The hypothalamus coordinates patterns of activity and controls emotions. It is also the control center for the pituitary gland.
Meninges
The meniniges are the thin covering layers of the brain and spinal cord. A tumor in this location usually causes symptoms by pressure and compression rather than by growth into brain tissue. Seizures are common. Additional symptoms depend on the location of the tumor.
Midline
The "midline" is where the two cerebral hemispheres meet. Headaches, nausea and a swollen optic nerve are the most common symptoms associated with this area and are due to increased intracranial pressure. Other symptoms are abnormal eye movements and vision, and alteration of personality or consciousness. In addition, impairment of glandular functions can cause either delayed or accelerated growth. The development of a water balance problem is possible.
Optic Tract
Symptoms associated with a tumor in this location involve the eye and vision, such as eye movement disorders, abnormal pupil reactions and impaired vision. In addition, production of hormones can be affected due to the tumor's effect on the nearby pituitary. See Midline Tumor.
Pineal Region
A tumor in this location causes hydrocephalus with the symptoms of increased intracranial pressure. Problems with eye movement often occur. In children, hormonal disturbances such as precocious puberty may occur.
Pituitary
The pituitary is called the "master gland." It secretes several important hormones. A tumor in this gland may cause headache, vision changes, and/or diabetes insipidus (a type of hormone disturbance). Because these tumors often secrete hormones inappropriately, other symptoms vary depending on the type of hormone secreted. Breast enlargement and secretion are common.
Posterior Fossa
The posterior fossa contains the fourth ventricle, cerebellum and brain stem. Headaches due to the tumor and/or hydrocephalus, nausea and vomiting, and a swollen optic nerve due to increased intracranial pressure are the most common symptoms. A clumsy, uncoordinated walk, swaying, and staggering might occur. Dizziness, tremors, as well as difficulty with coordination and speech, are also frequent symptoms. Double vision can occur. Nerve irritation can cause pain in the back of the head or neck or tilting of the head.
Skull BaseA wide variety of structures in the brain and head might be affected by a tumor in this location. Symptoms depend on the specific structure affected. Cranial nerves are often affected causing slurred speech, swallowing difficulties, double vision and facial weakness. Balance problems can occur.
Thalamus
The thalamus monitors input from the senses and acts as a relay station for the sensory center of the cerebrum. Common symptoms of a tumor in the thalamus include sensory loss such as the sense of touch on the side of the body opposite the side of the tumor; muscle weakness; decreased intellect; vision problems; speech difficulties; loss of urinary control; headache, nausea and vomiting and difficulties in walking due to the increased pressure caused by obstructive hydrocephalus.
Third Ventricle
Hydrocephalus due to the blockage of cerebrospinal fluid is very common, causing symptoms of increased intracranial pressure. Leg weakness, fainting spells, impaired memory and hypothalamic dysfunction are frequent symptoms. See Hypothalamus Tumor.
  If you are concerned about symptoms you are experiencing, please call your doctor. This material is not intended as medical advice. The symptoms listed can have many different causes; your doctor can listen to your concerns and help you find the cause of yoursymptoms.

June, 2010

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