Principal Director & HOD, Neuro and Spine Surgery, Fortis Hospital, Shalimar Bagh, New Delhi
Part 3 of 9 in Diagnosis and Management of Brain Tumour
Brain Tumour Symptoms and Which Headaches Are Red Flags
June 9, 2024
Brain tumours can present with a wide range of symptoms, and recognising which headache characteristics are genuinely concerning is important for deciding when to image.
Common symptoms
Recurrent headaches, particularly when associated with repeated vomiting, are a common presenting symptom. Other symptoms include seizures (fits), vision problems or hearing loss with recurrent giddiness, weakness or paralysis in specific body parts, memory loss or recent behavioural change, numbness in the limbs, personality changes, imbalance while walking, and severe facial pain or abnormal facial movements. Symptoms alone cannot distinguish a benign tumour from a malignant one; both can present identically.
Which headaches warrant concern
Not every headache should raise suspicion of a tumour. The characteristics that point towards a brain tumour are: an early-morning headache, a headache that worsens with coughing, sneezing or exercise, a headache that is relieved by vomiting, and a new-onset headache unlike anything the patient has experienced before.
This article is based on a Jivo Masterclass session conducted by Dr. Sonal Gupta, Principal Director & HOD, Neuro and Spine Surgery, Fortis Hospital, Shalimar Bagh, New Delhi. The article has been summarised with the assistance of an AI tool from the original masterclass recording. Watch the full Masterclass recording
Looking for a neurosurgery or brain tumour consultation? Get in touch with the Jivo team
This guide is based on a live Jivo Masterclass: Dr. Sonal Gupta taught doctors across Africa on June 9, 2024.
FROM THE LIVE Q&A
Moderator
If an adult has a first-time seizure, is it correct to suspect a brain tumour as the cause?
Dr. Sonal Gupta
Every patient presenting with a seizure should have an MRI under the epilepsy protocol with contrast, since a CT scan can miss small lesions responsible for epilepsy. However, not all seizure disorders are caused by a brain tumour.
Frequently Asked Questions
How are childhood brain tumours identified and managed differently from adult ones?▼
Identification is the same as in adults. The surgical approach is also the same, but radiotherapy and chemotherapy protocols must be modified according to the child's age.
Can a brain tumour be detected in a newborn?▼
Yes. An ultrasound of the skull can be used as a screening test to check for excess fluid or a tumour, but an MRI is required for a definitive diagnosis even in a newborn.
What are the post-operative complications of brain tumour surgery?▼
Complications have come down to under 5% of cases. They include epilepsy, a haematoma (clot) at the surgical site, infection from open surgery, and, if the tumour is very large, the possibility that a portion has to be left behind.
Will children benefit from epilepsy surgery at an early age?▼
Yes. If a child is dependent on multiple anti-epileptic medications, surgery helps by reducing both the number of medications needed and their side effects.
A 19-year-old has been on epilepsy follow-up and medication for 10 years. The MRI is negative, but the EEG shows a slow-wave background. What is the next step?▼
This patient should be referred for a dedicated epilepsy workup.
What headache characteristics suggest a brain tumour?▼
Early-morning headache, headache that worsens with coughing/sneezing/exercise, headache relieved by vomiting, and a new-onset headache unlike any experienced before.
Can symptoms tell you whether a tumour is benign or malignant?▼
No - symptoms alone cannot differentiate between benign and malignant tumours; imaging and biopsy are needed for that.
In This Series: Diagnosis and Management of Brain Tumour
- 1.Brain Tumour
- 2.How Brain Tumours Are Classified: Benign, Malignant, Primary and Secondary
- 3.Brain Tumour Symptoms and Which Headaches Are Red Flags
- 4.Diagnosing Brain Tumours: CT, MRI and Beyond
- 5.Brain Tumour Surgery and Radiosurgery: Treatment Options Explained
- 6.Brain Tumour Surgery: Realistic Complication Rates and Recovery
- 7.Epilepsy Surgery: Who Needs It and How It Helps
- 8.Brain Tumours in Children and Newborns: Diagnosis and Management
- 9.Real Brain Tumour Cases: Weighing Surgery Against Radiosurgery