Symptoms of a Brain Tumor

Symptoms of a brain tumor can be mild and subtle or severe and life-threatening, and can include vomiting, seizures, balance problems, dizziness, personality changes, loss of consciousness, and more. While many people who have a brain tumor can experience headaches, usually, headaches are not the only symptom of a brain tumor.

Frequent Symptoms

Symptoms of brain tumors are associated with the location where the tumor is growing, and can also develop due to increased intracranial pressure (pressure in and around the brain).

For example, a tumor in the area of the brain that processes vision may result in losing a portion of your vision. A tumor in the area of the brain that controls balance may result in incoordination.

Increased intracranial pressure can produce a range of symptoms that affect areas of the brain near the brain tumor, and it can also affect areas of the brain that are located relatively far from the brain tumor.

Most brain tumor symptoms are also common with many other conditions.

Signs and symptoms of a brain tumor include: 

Seizures

Seizures are often the first symptom of a brain tumor (not headaches, as many believe).

There are several different types of seizures that can occur due to a brain tumor.

• Tonic-clonic (grand mal) seizures can cause the body to shake all over in varying levels of intensity. They typically begin as focal seizures in one area of the brain before quickly spreading within seconds to become generalized. There is usually loss of consciousness as well as loss of bladder and sometimes bowel control.
• Myoclonic seizures may cause bothersome muscle twitches without loss of consciousness.
• Sensory seizures may result in changes in vision such as seeing flashing lights, a strange sense of smell, smacking lips, or other sensory symptoms.
• Some seizures may cause a person to sit still and stare into space, not seeing their surroundings.
• Seizures may cause déjà vu-like experiences.

Headaches

Up to half of the people with brain tumors experience headaches. Brain tumor headaches tend to be dull and persistent, with throbbing headaches occurring less often.

Headaches due to a brain tumor are often worse in the morning and may get better throughout the day. They may cause pain all over or pain that's worse on one side of the head.

Additional symptoms, like vomiting, are usually present. Pain may also worsen with physical activity, sneezing, coughing, bending over, or bearing down while having a bowel movement. 

Vomiting

Vomiting, especially in the morning, with or without nausea, can be a symptom of a brain tumor. Vomiting due to a brain tumor is often triggered by an abrupt change in position (such as rolling over in bed).

Cognitive Changes

Brain tumors can affect many thinking and problem-solving skills. Sometimes these changes can be subtle, and a person who has a brain tumor may be able to keep their job or function socially, but something just might be a bit "off."

Cognitive changes caused by brain tumors include:

• Memory: Forgetfulness or slowed processing of information might not be alarming at first, but can worsen over time as the tumor grows.
• Problem-solving: Tasks such as doing simple math, writing sentences, setting up a chessboard, or following a recipe may become challenging.
• Concentration: A person may become more easily distracted and have problems staying on task. It may take longer to complete basic tasks than usual.
• Confusion: Symptoms can vary from mild confusion, such as not understanding the nuances of a conversation, to more extreme symptoms, such as not recognizing why routine events are happening.
• Spatial problems: Problems with spatial perception may cause clumsiness, or a previously good driver may have a car accident due to changes in depth perception.

Loss of Consciousness

Increased intracranial pressure can cause loss of consciousness for a few reasons:

• It can cause progressive fatigue, leading to unconsciousness.
• Pressure on the brainstem can cause sudden loss of consciousness and may progress to a coma. 

Personality or Mood Changes

Adults who have brain tumors sometimes experience personality changes. They may laugh at inappropriate times, have a sudden increased interest in sex, throw temper tantrums, become paranoid, or engage in risky behaviors. Symptoms of a brain tumor have also been known to mimic depression. 

Vision and Hearing Problems

Some brain tumors can cause visual or auditory disturbances.

• Problems with vision can include seeing flashing lights, double vision, blurring, or loss of vision (usually in one visual field).
• Auditory disturbances can include one-sided hearing loss or ringing in the ears.
  

Physical Changes

Brain tumors may cause weakness on one side of the body or face, clumsiness, dizziness, loss of balance, or stumbling. An abnormal gait can develop, and coordinated movements may become difficult. Difficulty swallowing may also be a symptom.

Speech Changes

Slurring of words or difficulty speaking clearly can occur. A person who has a brain tumor may have difficulty forming or finding words, say things that make very little sense, or not be able to understand what others are saying. 

By Tumor Location

Sometimes symptoms are very specific to the location in the brain where the tumor is located.

Frontal Lobe Tumors

The frontal lobes are in the area of the brain where thinking and judgment take place. Tumors in this area can cause an intellectual decline as well as a change in personality. Due to pressure on the olfactory nerve, they may also result in a loss of the sense of smell (anosmia). The ability to speak (expressive aphasia) may also be impaired. 

The posterior part of the frontal lobe controls strength on the opposite side of the body, so a tumor in this area can cause weakness on the opposite side of the body.

Temporal Lobe Tumors

The temporal lobes are involved in speaking and hearing. Tumors in this area can result in auditory hallucinations (hearing things), an inability to understand speech (receptive aphasia), and vision changes.

Symptoms such as deja vu experiences, depersonalization, and perceiving things as either larger or smaller than they really are may also occur.

Parietal Lobe Tumors 

A tumor in the parietal lobe at the top of the brain can cause changes in sensation on the opposite side of the body. This area of the brain is also important for coordinating different parts of the brain, and tumors may cause problems with orientation (like knowing up from down) or object recognition.

People with a tumor in this region may ignore one side of their body or experience spontaneous pain.

Occipital Lobe Tumors 

The occipital lobes at the back of the brain are involved in vision. Symptoms can vary from visual hallucinations to visual field defects (only seeing one or more sections of peripheral vision) to cortical blindness (vision loss despite a perfectly functioning eye).

Cerebellar Tumors

The cerebellum at the lower back of the brain is responsible for balance and coordination. Tumors in this region may cause incoordination similar to that associated with being drunk. These tumors also can cause difficulty with fine motor skills, such as writing or brushing teeth.

Brainstem Tumors

The brainstem is the relay station between the upper part of the brain and the spinal cord, and it also controls vital functions such as breathing and heart rate. Tumors in this area may cause numbness or weakness on the same or opposite side of the body from the tumor, double vision, uneven pupils, dizziness, droopy eyelids, and other symptoms.

Loss of consciousness may also occur, and a brain tumor in this region can be fatal. Tumors in the upper regions of the brain may cause pressure that results in brain tissue herniation (getting pushed) into the brainstem.

Pituitary Gland Tumors 

Tumors in or around the pituitary gland (such as a craniopharyngioma) may result in changes in energy level, menstrual irregularities, abnormal lactation (production of milk), and weight changes.

These tumors can also compress the optic nerves, leading to vision changes.

Sub-Group Indications

Signs and symptoms of brain tumors in children are often the same as those in adults.

Some additional symptoms that can affect children include:

• Irritability
• Incontinence
• Appetite changes
• Not reaching age-appropriate developmental milestones
• Behavior changes
• Turning the whole head to see something instead of moving the eyes

In infants, the fontanelles (soft spot on the skull where the plates have not yet closed) may bulge, and the baby may become fussy when their head is touched. 

Complications

Complications are often associated with tumor enlargement, but even a small tumor can have detrimental effects if it is near structures in the body that control vital functions. 

Complications of brain tumors include:

• Increased intracranial pressure: Because the skull is an enclosed, inflexible space, a growing brain tumor can lead to pressure on other areas of the brain. As brain tissue is physically squeezed, it can lose function or be pushed down toward or into the upper spinal cord. Herniation can cause dilated pupils, rapid breathing, an irregular heartbeat, and may cause death very quickly if not urgently treated. 
• Hydrocephalus: Often, a brain tumor obstructs the flow of fluid in the ventricles, the spaces where fluid flows. When this occurs, intracranial pressure increases, and symptoms of confusion, vision impairment, and loss of consciousness arise. Sometimes, the ventricular obstruction cannot be relieved, so fluid must be removed; often, a ventriculoperitoneal shunt must be placed.  
• Disruption of vital functions: When brain tumors affect the brainstem, they can interfere with breathing, heartbeat, and blood pressure, causing sudden, dangerous changes in these vital functions. This may cause a sudden emergency or even death. 

When to See a Healthcare Provider

It's important to remember that brain tumor symptoms overlap with those of many less serious problems, and most of the time, these symptoms are not indicative of a brain tumor. That said, finding a brain tumor early increases the chance that it can be treated and reduces the chance that it will cause further damage.

Call your healthcare provider to talk about your symptoms and they will tell you if you should go to the emergency room or make an appointment for an office visit.

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That said, any severe or sudden symptoms warrant a call to 911 or a trip to the emergency room.