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Brain tumor - adults

Contents of this page: • • • • • Alternative names Definition Causes, incidence, and risk factors Symptoms Signs and tests • • • • Treatment Support Groups Complications Calling your health care provider

Alternative names Glioblastoma multiforme - adults; Ependymoma - adults; Glioma - adults; Astrocytoma - adults; Medulloblastoma - adults; Neuroglioma - adults; Oligodendroglioma - adults; Meningioma - adults; Cancer - brain tumor (adults) Definition
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A tumor is any growth of abnormal cells, or the uncontrolled growth of cells. This article is about primary brain tumors. These start in the brain, rather than spreading to the brain from another part of the body. See also: • • Brain tumor - metastatic (cancer that has spread to the brain) Brain tumor - children
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Causes, incidence, and risk factors

Primary brain tumors include any tumor that starts in the brain. Tumors may be confined to a small area, invasive (spread to nearby areas), benign (not cancerous), or malignant (cancerous). Tumors can directly destroy brain cells. They can also indirectly damage cells by producing inflammation, compressing other parts of the brain as the tumor grows, causing swelling in the brain, and increasing pressure within the skull. Brain tumors are classified depending on the exact site of the tumor, the type of tissue involved, benign or malignant tendencies of the tumor, and other factors. Primary brain tumors can arise from the brain cells, the meninges (membranes around the brain), nerves, or glands. The cause of primary brain tumors is unknown. This is because they are rare, there are many types, and there are many possible risk factors that could play a role. Exposure to some types of radiation, head injuries, and hormone replacement therapy may be risk factors, as well as many others. The risk of using cell phones is hotly debated. Some inherited conditions increase the risk of brain tumors, including neurofibromatosis, Von Hippel-Lindau syndrome, Li-Fraumeni syndrome, and Turcot's syndrome.

location. seizures.a persistent headache that is new for the person. Because these tumors are difficult to cure. worse on awakening Vomiting -. Oligodendroglial tumors also can vary from low grade to very malignant. including glioblastoma. It is often difficult for a neurosurgeon to determine where the tumor ends. Some are cancerous and aggressive. radiation therapy.Tumors may occur at any age.possibly accompanied by nausea. and related swelling. Symptoms may include: • • • • Headache -. they still may cause devastating complications and death due to their size or location. These tumors can have varying degrees of malignancy. weakness in one part of the body. anaplastic astrocytomas. rapid emotional changes . Glioblastomas are the most aggressive type of primary brain tumor. oligodendrocytes. patients should consider enrolling in a clinical trial after talking with their treatment team. craniopharyngiomas. While 90% are benign. because the tumor invades surrounding brain tissue much like roots from a plant. The gliomas are subdivided into 3 types: • • • Astrocytic tumors include astrocytomas (less malignant). and ependymal cells. and others. and changes in the person's mental functions are most common. Headaches. but many specific tumors have a particular age group in which they are most common. degree of invasion. These tumors: • • • Occur most commonly between the ages of 40 to 70 Much more common in women. These may or may not arise from a prior lower grade primary brain tumor. Other primary brain tumors in adults are rare and can include ependymomas. These are called mixed gliomas. as well as experimental therapies in various combinations. In adults. More recently. gliomas and meningiomas are most common. Therefore. Some primary brain tumors are composed of both astrocytic and oligodendrocytic tumors. primary germ cell tumors of the brain. radiation oncologist. pituitary tumors. SPECIFIC TUMOR TYPES Gliomas are thought to be derived from glial cells such as astrocytes. these tumors are best treated by a team involving a neurosurgeon. Treatment can involve surgery. and glioblastomas (most malignant). and chemotherapy. Meningiomas are another type of brain tumor. and other types. more severe in the morning Personality and behavior changes Emotional instability. All of the above tumors can be difficult to remove completely by surgery alone. Symptoms Return to top The specific symptoms depend on the tumor's size. oncologist or neuro-oncologist. pineal gland tumors. such as neurologists and social workers. "molecular subtyping" of tumors is being used to make decisions about how to best treat a particular tumor. Astrocytomas can progress over time more malignant forms.

falls Fever (sometimes) Weakness. decreased vision Hearing loss Decreased sensation of a body area Weakness of a body area Speech difficulties Decreased coordination. Most brain tumors increase pressure within the skull and compress brain tissue because of their size and weight. absent temporarily Unusual or strange behavior Return to top • • • Signs and tests A doctor can often identify signs and symptoms that are specific to the location of the tumor. Some tumors may not show symptoms until they are very large and cause a rapid decline in the person's mental functions. Other tumors have symptoms that develop slowly. impaired judgment Seizures that are new for the person Reduced alertness Double vision.• • • • • • • • • • • • • • • Loss of memory. clumsiness. lethargy General ill feeling Positive Babinski's reflex Decerebrate posture Decorticate posture Additional symptoms that may be associated with primary brain tumors: • • • • • • • • • • • Tongue problems Swallowing difficulty Impaired sense of smell Obesity Uncontrollable movement Dysfunctional movement Absent menstruation Hiccups Hand tremor Facial paralysis Eye abnormalities o pupils different sizes o uncontrollable movements o eyelid drooping Confusion Breathing. The following tests may confirm the presence of a brain tumor and identify its location: • • • • • CT scan of the head MRI of the head EEG Examination of tissue removed from the tumor during surgery or CTguided biopsy (may confirm the exact type of tumor) Examination of the cerebral spinal fluid (CSF) may reveal cancerous cells .

and blood vessels outside the compartments in the head that they normally occupy. profound neurologic losses Loss of ability to interact or function Side effects of medications. Legal advice may be helpful in creating advanced directives. Support Groups Return to top For additional information. including chemotherapy Side effects of radiation treatments Return of tumor growth . Complications • Return to top • • • • • Brain herniation (often fatal) o Uncal herniation o A brain herniation is the displacement of brain tissue. Anticancer medications (chemotherapy) may be recommended. Radiation therapy may be advised for tumors that are sensitive to radiation. safety measures. A herniation can occur through a natural opening at the base of the skull (called the foramen occipitalis) or through surgical openings created by a craniotomy procedure. surgery may still help reduce pressure and relieve symptoms. The treatment approach varies with the size and type of the tumor and the general health of the person.Treatment Return to top A primary brain tumor should have prompt treatment. progressive. The goals of treatment may be to cure the disorder. physical therapy. such as power of attorney. support groups and similar measures may be needed to help in coping with the disorder. see cancer resources. Counseling. Early treatment improves the chance of a good outcome for many tumors. occupational therapy and other such steps may be required to improve quality of life. relieve symptoms. Some may be completely removed. o Foramen magnum herniation Permanent. and improve brain function or the person's comfort. Other medications may include the following: • • • • • Corticosteroids such as dexamethasone to reduce brain swelling Osmotic diuretics such as urea or mannitol to reduce brain swelling and pressure Anti-convulsants such as phenytoin to reduce seizures Pain medications Antacids or histamine blockers to control stress ulcers Comfort measures. cerebrospinal fluid. In cases where the tumor cannot be removed. Tumors that are deep or that infiltrate brain tissue may be debulked (reducing the tumor's size and mass) rather than removed. Surgery is neccessary for most primary brain tumors. in cases where the person's condition is expected to get worse.

D. or suddenly develop stupor (reduced alertness).Calling your health care provider Return to top Call your health care provider if you develop any new. CT. Chief of Hematology/Oncology and Director of the George Bray Cancer Center at New Britain General Hospital. persistent headaches or other symptoms suggestive of a brain tumor. . Review provided by VeriMed Healthcare Network. Ph. vision changes.. or speech changes. New Britain. M.D. Update Date: 11/16/2004 Updated by: Stephen Grund. Call your provider or go to the emergency room if you have seizures that are new.