SYMPTOMS AND SIGNS OF A BRAIN TUMORThere are general symptoms due to the presence of a mass in an almost rigid box (the skull) and specific symptoms depending on the location of the brain tumor. Both may be present in the same patient. A list follows. This is a gross list, as this is not a medical textbook. It just helps understand the medical language.
This is an inflammation of the brain. In severe trauma, toxic conditions and encephalitis, the edema is generalized, i.e. all the brain areas are involved, with severe intracranial hypertension syndrome. In brain tumors, the edema is around the lesion and contributes to developing a "mass effect". Brain edema may be severe. It is the expression of the biological activity of the tumor. It is very frequent in malignant gliomas and metastases. Also benign tumors, such as meningiomas, may cause brain edema. The peritumoral edema is generally responsible for the patient's clinical symptoms and seizures. However, this kind of edema, as well as the patient's conditions, may improve dramatically in a matter of few days with high-dose corticosteroid therapy.
It is frequent in people with brain tumor. It is a gravative and "new" headache vs. other headaches experienced in one's own life. Sometimes, vomiting and nausea are associated with severe headache. In case of brain tumor headaches, common drugs are ineffective. A real alarm is a severe new headache lasting for 3-4 weeks. People with habitual headaches must pay attention to the "new kind" of headache.
Intracranial Hypertension Syndrome
A brain tumor occupies volume in an almost rigid box. The brain inside the box offsets and adapts to the lessened space until equilibrium is broken. Then, the pressure inside the skull rises and becomes clinically manifest: severe headache, vomiting, drowsiness, occasional psychomotor agitation, temporo-spatial disorientation.
The person involved has lost his/her memory. In particular, he/she does not recall recent facts. It is frequent in frontal and temporal brain tumors. It may be associated with sphincteric incontinence and lack of attention and concentration.
It is a speaking or understanding disorder, expressing damage to the frontal, temporal or parietal areas of the dominant hemisphere: the left in right-handed people, the right in left-handed. The aphasia group may include other major cognitive deficits: dyslexia, right-left disorientation and so on.
This is the inability to perform an action in spite of functioning motor and sensory pathways and cortex. The person no longer knows how to perform an action (e.g. taking his/her hat, cutting his/her food). It may be the expression of corpus callosum damage.
This is the lack of coordination. It may be due to cerebellar lesions and to damage of the sensory tracts or cortex. A person with this condition is unable to recognize and/or control his/her body or limbs in space.
Cranial Nerve Deficits
These may be due to damage of olfactory, optic and oculomotor nerves. A damage of the optic nerve leads to loss of vision; damage of oculomotor nerves causes double vision or diplopia. Facial paralysis is due to facial nerve damage. Swallowing paralysis is due to damage of the IX and X cranial nerves (for details, see Chapter 1).
This is the analogous sensory deficit.
It is the expression of damage to the optic pathways. It has different characteristics, depending on the site of the lesion or cause: optic nerve, chiasm, tract, radiations, cortex.
This is the motor deficit of the opposite part of the body. It occurs when the motor cortex, the paths along the internal capsule or the brainstem are damaged.
It is a partial or complete motor deficit of the lower limbs, secondary to damage of the spinal cord under the cervical tract. If the latter tract is involved, then also the upper limbs are unable to move and the disease is called tetraparesis and tetraplegia. It is generally associated with sphincteric disturbances and severe trophic changes of the skin and tissues. Under the site of the lesion, sensitivity may be lost.