<p>In recent times, brain tumours are being diagnosed more frequently, thanks to technological advancements and newer diagnostic modalities. These tumours exhibit symptoms mainly because of their locations, sizes and the fact that they are in a closed space. Commonly, brain tumours are classified in two types:<br /><br /></p>.<p>Benign- These are non-cancerous, slow growing and well-defined, and are not usually deeply rooted. These present symptoms when they attain bigger sizes and start compressing their surrounding areas. They usually do not recur.<br /><br />Malignant- These are cancerous tumours that are rapidly growing and ill-defined. They present symptoms early in the course of the disease. They are known to recur and may need adjuvant chemotherapy or radiotherapy. These are some possible common symptoms of brain tumour:<br /><br />Headache in the early morning hours is one of them. It may be severe, throbbing and located at both frontal regions. It is usually severe in the beginning and fades away as the day progresses. It may be associated with vomiting. This does not respond to usual painkillers.<br /><br />Nausea and vomiting is another. The patient feels sick and develops nausea frequently.<br />Blurring of vision, loss of vision, diplopia (double vision), usually appears late.<br />Fits (seizures) are one of the most common symptoms of brain tumours. They appear in one in four people. A seizure can be jerking or twitching of a hand, arm or leg or may affect the whole body. Some fits just cause a moment of unconsciousness. And if your brain tumour is successfully treated, the fits may stop completely. Adults over 40 years of age having their first seizure need to be evaluated for brain tumours. These are some symptoms related to location of the tumour:<br /><br />In the frontal lobe (it may take long time to be symptomatic)<br /><br />Changes in personality (depression, rage, anti-social behaviour, impulsiveness)<br />Loss of inhibitions<br />Losing interest in life<br />Difficulty with planning and execution<br />Loss of recent memory<br />Weakness in part of the face, or on one side of the body<br />Difficulty in walking<br />Loss of sense of smell<br />Problems with sight or speech<br />Incontinence of urine<br /><br />In the temporal lobe<br /><br />Difficulty in naming objects, loss of comprehension<br />Difficulty finding the correct word<br />Short term memory loss<br />Fits associated with strange feelings, smells or déjà vu<br />Hearing voices in the head<br />Visual loss<br /><br /> In the parietal lobe<br /><br />Difficulty speaking or understanding what is said to you<br />Problems with reading or writing<br />Loss of feeling in part of the body<br />Inability to appreciate texture of different object<br />Right & left disorientation<br />Difficulty in writing and calculation<br /><br />In the pituitary gland<br /><br />Irregular or infrequent periods<br />Infertility in men and women<br />Lack of energy<br />Weight gain<br />Mood swings<br />blood pressure<br />Diabetes<br />Enlarged hands and feet<br /><br />Some tumours can mimic acute stroke like glioblastoma, pituitary tumour and meningiomas, because of intratumoural bleed. Acoustic neuroma, which arises between the brain stem and cerebellum can cause facial pain resembling trigeminal neuralgia because of compression over trigeminal nerve. Pituitary tumour, craniopharyngiomas, meningiomas can present with blindness or visual field defects. Temporal tumours can present as seizures of typical nature characterised by sense of abnormal smell, sudden loud cry, followed by abnormal movements.<br /><br />It is important to remember that there are many other causes for the symptoms mentioned above. If you are worried, you need to go to a doctor. They will send you to a specialist if they think there is any possibility that you could have a brain tumour. Sometimes, tumours in the frontal or temporal lobes of the cerebrum can become quite large with very few symptoms. In the elderly, vague symptoms of memory loss, personality changes and difficulty in walking can be put down to getting older. If several symptoms like these develop over less than six months, it is worth checking with your doctor.<br /><em><br />(The author is neurosurgeon, Narayana Multispecialty Hospital, Bengaluru)</em></p>
<p>In recent times, brain tumours are being diagnosed more frequently, thanks to technological advancements and newer diagnostic modalities. These tumours exhibit symptoms mainly because of their locations, sizes and the fact that they are in a closed space. Commonly, brain tumours are classified in two types:<br /><br /></p>.<p>Benign- These are non-cancerous, slow growing and well-defined, and are not usually deeply rooted. These present symptoms when they attain bigger sizes and start compressing their surrounding areas. They usually do not recur.<br /><br />Malignant- These are cancerous tumours that are rapidly growing and ill-defined. They present symptoms early in the course of the disease. They are known to recur and may need adjuvant chemotherapy or radiotherapy. These are some possible common symptoms of brain tumour:<br /><br />Headache in the early morning hours is one of them. It may be severe, throbbing and located at both frontal regions. It is usually severe in the beginning and fades away as the day progresses. It may be associated with vomiting. This does not respond to usual painkillers.<br /><br />Nausea and vomiting is another. The patient feels sick and develops nausea frequently.<br />Blurring of vision, loss of vision, diplopia (double vision), usually appears late.<br />Fits (seizures) are one of the most common symptoms of brain tumours. They appear in one in four people. A seizure can be jerking or twitching of a hand, arm or leg or may affect the whole body. Some fits just cause a moment of unconsciousness. And if your brain tumour is successfully treated, the fits may stop completely. Adults over 40 years of age having their first seizure need to be evaluated for brain tumours. These are some symptoms related to location of the tumour:<br /><br />In the frontal lobe (it may take long time to be symptomatic)<br /><br />Changes in personality (depression, rage, anti-social behaviour, impulsiveness)<br />Loss of inhibitions<br />Losing interest in life<br />Difficulty with planning and execution<br />Loss of recent memory<br />Weakness in part of the face, or on one side of the body<br />Difficulty in walking<br />Loss of sense of smell<br />Problems with sight or speech<br />Incontinence of urine<br /><br />In the temporal lobe<br /><br />Difficulty in naming objects, loss of comprehension<br />Difficulty finding the correct word<br />Short term memory loss<br />Fits associated with strange feelings, smells or déjà vu<br />Hearing voices in the head<br />Visual loss<br /><br /> In the parietal lobe<br /><br />Difficulty speaking or understanding what is said to you<br />Problems with reading or writing<br />Loss of feeling in part of the body<br />Inability to appreciate texture of different object<br />Right & left disorientation<br />Difficulty in writing and calculation<br /><br />In the pituitary gland<br /><br />Irregular or infrequent periods<br />Infertility in men and women<br />Lack of energy<br />Weight gain<br />Mood swings<br />blood pressure<br />Diabetes<br />Enlarged hands and feet<br /><br />Some tumours can mimic acute stroke like glioblastoma, pituitary tumour and meningiomas, because of intratumoural bleed. Acoustic neuroma, which arises between the brain stem and cerebellum can cause facial pain resembling trigeminal neuralgia because of compression over trigeminal nerve. Pituitary tumour, craniopharyngiomas, meningiomas can present with blindness or visual field defects. Temporal tumours can present as seizures of typical nature characterised by sense of abnormal smell, sudden loud cry, followed by abnormal movements.<br /><br />It is important to remember that there are many other causes for the symptoms mentioned above. If you are worried, you need to go to a doctor. They will send you to a specialist if they think there is any possibility that you could have a brain tumour. Sometimes, tumours in the frontal or temporal lobes of the cerebrum can become quite large with very few symptoms. In the elderly, vague symptoms of memory loss, personality changes and difficulty in walking can be put down to getting older. If several symptoms like these develop over less than six months, it is worth checking with your doctor.<br /><em><br />(The author is neurosurgeon, Narayana Multispecialty Hospital, Bengaluru)</em></p>
