What are the signs and symptoms of brain tumours?

The most common signs and symptoms

In the early stages, brain tumours most commonly cause headaches and feeling sick (nausea). These symptoms are usually caused by a rise in the pressure within the brain as the tumour grows. The rise in pressure is called raised intracranial pressure (ICP).

Of course, many other things can cause headaches or feelings of sickness, but if you have either of these for over a week with no sign of getting better, it is important to see your doctor.

A pressure headache may be most severe in the mornings, and can occasionally wake you. Usually this type of headache gets better during the day. However, it may get worse when you cough, sneeze, bend down or do any hard physical work. All of these tend to raise pressure in the brain.

If the raised pressure makes you sick, this may also be worse in the morning and can lessen during the day. You may be sick if you have hiccups.

As well as the symptoms described above, raised intracranial pressure can also cause changes in your sight and make you confused or affect your balance.

Another common symptom caused by brain tumours is epilepsy, which can cause fits, muscle spasms, or moments of unconsciousness. A fit is a frightening experience, but is not necessarily caused by a brain tumour. However, it is important to seek medical help so that the actual cause can be diagnosed and suitably treated.

Symptoms connected with the tumour’s position

Some symptoms may be caused by tumours in particular areas of the brain. In general, each area of the brain controls particular functions, and a tumour may prevent a particular area of the brain from working normally.

Some of these symptoms are listed below, grouped under the different parts of the brain. They are included only as a guide. Exact diagnosis can only be made by a doctor and confirmed by tests.

The diagram showing the lobes and functions of the brain shows the different functions of each area of the brain.

• Frontal lobe tumours – Changes in personality and intellect. Unco-ordinated walking or weakness of one side of the body. Loss of smell, occasional speech difficulties.
• Parietal lobe – Difficulty in speaking or understanding words. Problems with writing or reading. Difficulty in co-ordinating certain movements. Difficulty finding your way around. Difficulty with numbers (doing simple calculations). Numbness or weakness on one side of the body.
• Occipital lobe – Loss of vision on one side. The person may not notice this at first and it may sometimes be discovered during routine eye tests.
• Temporal lobe – Fits may cause strange sensations: a feeling of fear or intense familiarity (dé jà vu), strange smells or blackouts. Speech difficulties and memory problems.
• Cerebellum – Lack of co-ordination which affects walking and speech (dysarthria), unsteadiness, flickering involuntary movement of the eyes (nystagmus). Vomiting and neck stiffness.
• Brain stem – Unsteadiness and an unco-ordinated walk. Facial weakness, a one-sided smile or drooping eyelid. Double vision. Rarely, vomiting or headache just after waking; difficulty in speaking and swallowing. Symptoms may appear gradually.

All the above symptoms may be caused by conditions other than a brain tumour. If you have any of the symptoms described it is important that you go and see your family doctor (GP).

Personality changes

Sometimes brain tumours may cause changes in personality or behaviour. These symptoms usually occur when the tumour is in the brain’s cerebral hemispheres. This situation can be very frightening for the patient and their family. Sometimes a referral for psychological support can help to assess the extent of the problem and look at ways of coping with it.

Driving

As brain tumours can cause changes in the way that your brain works, this may make it dangerous for you to drive. In the UK, there are laws which restrict some people with brain tumours from driving for a time. The restrictions vary with the type of tumour you have, and the type of driving license you hold. However, for all brain tumours (except some pituitary tumours) you will not be able to drive for at least a year after the condition has been diagnosed, and in some circumstances you may not be able to drive again. It is your responsibility, not your doctors’, to tell the Drivers and Vehicle Licensing Authority (DVLA) about your illness. The DVLA will advise of you of any restrictions on your right to drive.