Signs & Symptoms

Symptoms of a brain tumor can vary depending on the tumor’s size, type, and location.

Here is a list of the most common brain tumor signs and symptoms, along with suggestions for ways to reduce their impact on your life.

Be sure to discuss any new symptoms, or changes in existing symptoms, with your healthcare team as soon as possible. It is important to talk with your doctor about all of your symptoms and to keep your medical team updated about how your symptoms change over time. Your doctor can help you treat your symptoms and minimize their impact on your life.

 

Headaches

Among the most common of all brain tumor symptoms, headaches have a range of types and causes. About half of all people with a brain tumor report experiencing headaches.

Many brain tumor patients describe their headaches as a persistent pain with the following features:

  • Steady pain, but different than a migraine headache
  • Worse when you first wake up, getting a bit better over the next few hours
  • May be accompanied by vomiting
  • May be accompanied by new neurological problems
  • May or may not be throbbing (depending on the tumor’s location)
  • May get worse with coughing, exercise, or a change in position
  • Does not respond to over-the-counter pain medication (like aspirin or ibuprofen)

Causes of brain tumor headaches

Brain tumor-related headaches are generally the result of the tumor (or tumor-related fluid buildup) pressing against the brain’s sensitive blood vessels and nerves.

How to handle headaches

Here are some suggestions for managing headache pain caused by a brain tumor:

    • Treat with the medication your doctor prescribes.
    • Tell your doctor right away if the medication stops working or becomes less effective.
    • Keep a “headache journal.” It may be helpful for your doctor to have a record of the headaches, particularly if they are becoming worse. Some questions to consider:
      • What does the pain feel like? Sharp? Stabbing? Dull? Pounding? Achy? Tingling?
      • Is it accompanied by nausea, vomiting, or changes in vision?
      • Where is the pain located? All over? Head only? Abdomen? Limbs? Elsewhere?
      • On a scale of 1 to 10, with 1 being no pain and 10 being the worst pain imaginable, how would you rate the pain?
      • How long has the pain lasted?
      • Does it move around or stay in one place?
      • Does it come and go, or is it there all the time?
      • Does it seem to happen in relation to something else (e.g., eating, standing suddenly, reaching, or after a change in medication or dose)?
      • Is there anything that makes the pain better or worse?
      • Does pain medicine help? If so, how much?
    • Call 911 or go to the emergency room if:
      • The headache is accompanied by a fever or stiff neck.
      • The headache is the highest degree of pain on the pain scale (ask your doctor or nurse for details).
      • There is a significant change in mental status or unresponsiveness

Headache Information Page, National Institutes of Health

Medline Plus: Headache, U.S. National Library of Medicine

Seizures

A seizure is an episode caused by abnormal electrical activity in the brain. Common features of seizures include:
  • Sudden onset
  • Loss of consciousness and body tone, followed by twitching and relaxing muscle contractions
  • Loss of control of bodily functions
  • Short periods of no breathing (30 seconds); skin may turn dusky blue
  • Short duration (2-3 minutes)
After the seizure passes, the person may feel sleepy or confused, have a headache or sore muscles, or experience brief weakness or numbness. There are many different types of seizures, depending on which area of the brain has the abnormal electrical signals. Seizures can be common in people with brain tumors. In some cases, a seizure is the first clue that an individual has a brain tumor.

Causes of seizures

Normally, your body’s nerve cells communicate with each other through carefully controlled electrical signals. If something interferes with these signals, or communication pathways become compressed, stretched, or blocked, it can result in a seizure.

How to handle seizures

Most seizures can be controlled with medicines called anti-epileptic drugs (AEDs). Surgery to remove the tumor may also stop or reduce seizure activity.
Before a seizure:
Seizures can happen at random – at any time, and with no particular trigger. However, there are sometimes warning signs that signal when a seizure is about to occur. People who regularly have seizures sometimes notice things that may signal an oncoming episode. This warning is called an “aura.” Auras vary by individual and can take the form of a headache, a change of mood, a muscle twitch, or a particular smell.
After a seizure:
  • Allow time for recovery.
  • Communicate with your doctor if this is a new symptom.
  • If you are taking an anti-epileptic medication, ask the doctor if the seizure medication dosage needs to be adjusted.
  • Maintain a record of seizure symptoms, including how long they last and how often they occur.
For some tips to help you care for a person having a seizure, order a Seizure First Aid wall cling.

Seizure First Aid, U.S. Centers for Disease Control & Prevention

Medline Plus: Seizures, U.S. National Library of Medicine

Memory Loss

Brain can tumors often affect memory. Changes in a patient’s short-term memory are often more noticeable than effects on long-term memory.

Memory terms to know

  • Short-term memory: Short-term memory is where we store information we need to remember for just a few seconds or minutes. Remembering a phone number we’re just about to dial is an example.
  • Long-term memory: Long-term memory is for information that is stored for more than just a few minutes. Our family’s names are stored in our long-term memories.
  • Encoding/acquisition: The process by which our brains gather information, organize it, and process it for storage.
  • Consolidation: The process by which our brains move information from short-term to long-term memory.
  • Retrieval: The process by which previously learned information is remembered or brought into awareness.

Memory problem causes

A patient’s brain tumor can cause memory problems. Treatment like surgery or radiation may also cause memory problems. Fatigue, which is common in patients with brain tumors, can make these issues even worse.

How to handle memory problems

The more active your brain is, the more connections you’ll build within it. Any activity you enjoy that stimulates the brain has the potential to be helpful—reading, writing, and working on crossword puzzles are good examples. Here are some tips to help improve your memory in general:
  • Get plenty of sleep.
  • Eat regular, well balanced meals and drink plenty of liquids.
  • Adjust your surroundings to enhance your attention span. Some people perform better in a quiet, distraction-free environment, while others need more stimulation.
If you have problems with encoding/acquisition and consolidation:
  • Minimize distractions.
  • Focus on only one thing at a time, if possible.
  • If it’s important, repeat it. Even better, repeat it back in your own words.
  • Ask questions where appropriate; more information makes for better learning.
  • Try to associate the information with something meaningful to you.
  • Keep things as structured and organized as possible.
  • Designate a specific place to keep important things like your keys or wallet.
  • Arrange information under a common theme; “chunk” or group the information.
  • Make lists.
  • Use calendars, daily planners, electronic organizers.
  • Use a memory notebook.
  • Use Post-it notes.
  • Set alarm clocks/timers as reminders.
If you have problems with retrieval:
  • Use cues and reminders to help you remember.
  • Use an alarm clock or timer.
  • Use a memory notebook.
  • Use a daily planner.
  • If you are a visual learner:
    • Use written lists.
    • Visualize the information you want to remember (i.e., picture the story as it’s being told).
    • When you can, sketch it out.
  • If you are an aural (listening) learner:
    • Get the information verbally; if it’s a drawing or map, talk it out.
    • Read the information out loud (engaging more than one sense may help you remember).
    • Tape record important information.
    • Take notes.

Model Systems Knowledge Translation Center, Cognitive Problems After Traumatic Brain Injury

Depression

Clinical, or major, depression goes far beyond a case of “the blues.” Major depression is persistent and can interfere with every aspect of daily life. Symptoms may include prolonged feelings of sadness that is often disproportionate to the situation, loss of interest or pleasure in things that used to be enjoyable, feelings of worthlessness or guilt, insomnia, decreased energy, and even thoughts of suicide. Depression is common among both brain tumor patients and their loved ones. Estimates suggest that more than 1 in 4 people with a brain tumor suffer with a major depressive disorder. Although depression is a common reaction to a brain tumor diagnosis, there are options available to help you feel better.

How to handle depression

It is critical that you are able to identify the signs and symptoms associated with depression and get help. By carefully looking for symptoms of depression, you may be the first to identify this important issue and alert the doctor to your concerns. Your doctor can perform a formal evaluation, and, if you are diagnosed with depression, help you get effective treatment. It is important to remember that depression is not a sign of weakness, but rather a common occurrence during the treatment for brain tumors. Untreated depression can slow the rates of recovery and cause other health problems. Getting help for depression should be part of your brain tumor treatment plan for your mental health and well-being. Treatment for depression typically consists of medication and/or “talk” therapy.

National Institute of Mental Health, Depression

Mood Swings

Mood swings are sudden, unexplained changes in mood. You can be content one moment, and very angry the next without any reason why. Mood swings are common among people diagnosed with a brain tumor.

The causes of mood swings

A brain tumor can cause mood swings by disrupting brain function.

How to handle mood swings

It is important to tell your doctor if you or your caregiver notices mood swings. In some cases, medication can be prescribed to help prevent or lessen mood swing symptoms.

Personality Changes

Unlike tumors in another part of the body, brain tumors have the ability to affect a person’s personality. Someone who was once driven and motivated before a brain tumor diagnosis can now be passive and inhibited. Or someone who was once described as sweet and kind could become irritable and controlling. This is one of the most difficult symptoms for caregivers to live with. Loved ones can feel frustration or sense of loss for the person they knew “before.”

The causes of personality changes

A brain tumor can cause personality changes by disrupting brain function. The tumor’s location, size, and growth rate can have a lot to do with how a patient thinks and acts. Treatments such as radiation, surgery, and chemotherapy can also have an effect. The psychological and emotional effects of brain tumors are important to consider as well.

How to handle personality changes

If you or your caregiver notice changes in personality, it is import to tell your doctor.

National Library of Medicine. Psychiatric Aspects of Brain Tumors: A Review

Cognitive Changes

Changes in cognitive function – the brain’s ability to reason, remember, and learn – are a common symptom among brain tumor patients. In some cases, these changes are so subtle that the patients themselves are more aware of their difficulties than are those around them. In others, it is the caregiver rather than the patient who first recognizes that something is different. Cognitive changes commonly fall into a few broad categories:
  • Language and communication: Difficulty with verbal fluency (speaking, reading, and/or writing).
  • Attention and concentration: Confusion, easy distraction, difficulty multitasking and planning.
  • Executive functioning/general intellectual abilities: Decreased reasoning ability, impaired judgment, inability to connect cause and effect.
Behavior changes often depend on the area of the brain affected by the tumor. Tumors in the frontal, temporal, and parietal lobes can affect behavior
  • Frontal lobe: Movement, intelligence, reasoning, behavior, memory, personality, planning, decision making, judgment, initiative, inhibition, mood.
  • Temporal lobe: Speech, behavior, memory, hearing, vision, emotions.
  • Parietal lobe: Intelligence, reasoning, telling right from left, language, sensation, reading.

Causes of cognitive changes

The tumor’s location, size, and growth rate can have a lot to do with how a patient thinks and acts. Treatments such as radiation, surgery, and chemotherapy can also have an effect. The psychological and emotional effects of brain tumors are important to consider as well.

How to handle cognitive changes

As a first step, it’s a good idea to undergo a complete neuropsychological evaluation. This detailed evaluation of your current behavioral, cognitive, and emotional status can help identify specific issues and assist your treatment team in determining how to help. Different behavioral issues are addressed in different ways:
  • Language & communication: Speech and language therapy, cognitive rehabilitation therapy
  • Emotional & personality: Cognitive rehabilitation therapy, psychotherapy, medication
  • Learning & memory: Cognitive rehabilitation therapy, speech and language therapy
  • Attention & concentration: Cognitive rehabilitation therapy, medication
  • Executive functioning/general intellectual abilities: Cognitive rehabilitation therapy, problem-solving therapy

Neuropsychiatric Symptoms

Brain tumors can cause a number of mood, behavioral or cognitive symptoms that present or overlap like mental health disorders. If untreated, these symptoms can cause significant change in the patient’s personality, mood, and behavior. In extreme cases, these changes can lead to situations in which the patient, their caregiver, loved ones or others are placed at risk. Examples of neuropsychiatric symptoms include aggression, delusion, hallucination, impulsivity, mania, paranoia, psychosis, and violent behavior.

Causes of Neuropsychiatric Symptoms

Neuropsychiatric symptoms related to a brain tumor can have several causes, including tumor location, injury caused by the tumor, age, general health, and other health issues.

How to Handle Neuropsychiatric Symptoms

Health care providers can help address neuropsychiatric symptoms. Strategies to address these symptoms include surgery, radiation, steroids, lifestyle changes, psychiatric medications, and counseling/psychotherapy.

Neuropsychiatric Symptoms Brochure

Fatigue

Fatigue is a common brain tumor symptom. It can include:

  • A profound lack of energy
  • Feeling suddenly tired
  • Weakness
  • A heavy feeling in your limbs
  • Difficulty concentrating
  • Irritability
  • Sleeplessness

How to handle fatigue

Adjust your lifestyle
  • Accept that you’re going to need some down time.
  • Keep track of when your energy is up or down, and plan your days accordingly.
  • Figure out what activities you can let go of or delegate to a friend, family member, caregiver, or professional.
  • Set up your environment so that you spend as little energy as possible on daily tasks.
  • Ask your doctor about meeting with an occupational therapist to learn energy-conservation strategies.
Eat for energy
  • Eat small, frequent meals that combine complex carbs with vegetables, dairy, and some protein to keep your energy stable.
  • If you have the energy to cook, focus on fresh ingredients that have lots of nutritional value.
  • Prepare your food sitting down.
  • Cook in large batches.
  • Use kitchen time savers, from pre-cut veggies to disposable pans.
Get a little exercise
  • Check with your healthcare team before starting any exercise or fitness plan.
  • Try moderate exercise to boost your energy level – walking and yoga are good choices.
Focus on sleep
  • Go to bed at the same time every night.
  • Set a consistent routine to wind down for sleep.
  • Avoid screens (phone, TV, or computer) for at least one hour before bed.
  • Add short naps (less than one hour) to your routine in the early afternoon to give you an energy boost.
Take a break
  • Don’t let worries drain your energy – look into meditation, guided imagery, music therapy, yoga, or other complementary therapies to help calm your mind.
  • Find a place where you feel peaceful and spend time there alone.
  • Give time to activities that you enjoy and that take your mind off your symptoms.

Mass Effect

Mass effect happens when a brain tumor presses on the normal tissue around it. Nausea and vomiting, drowsiness, vision problems, headaches, and behavior changes are common symptoms.

Causes of mass effect

Mass effect is caused by increased intracranial pressure, also known as ICP. This increased pressure in the brain may be caused by several factors:

  • A tumor growing within the tight space of the skull
  • The fluid that flows around and through the brain is blocked (hydrocephalus)
  • The area of the brain near the tumor is swelling because fluid is building up (edema)

How to handle mass effect

Prompt treatment is required to avoid serious consequences. If you or a loved one is experiencing vision changes, severe/sudden-onset personality changes, vomiting, or severe head pain, seek emergency medical help.

Focal Symptoms

Focal, or localized, symptoms are those that affect a particular area of the brain. They can often help identify the location of the tumor. Examples include:

  • Hearing problems (such as ringing or buzzing sounds or hearing loss)
  • Decreased muscle control
  • Lack of coordination (feeling clumsy)
  • Decreased sensation (feeling numb or tingly)
  • Weakness or paralysis
  • Difficulty walking or speaking
  • Balance problems
  • Double vision

Causes of focal symptoms

Focal symptoms are caused by the tumor itself and its specific location in the brain.

How to handle focal symptoms

Managing focal symptoms varies depending on the type of tumor causing the symptoms as well as the tumor’s location.

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Mindee Plugues

Member

Mindee J. Plugues, of Los Angeles, CA, is vice president, marketing for the Applebee’s brand and brings skills including brand strategy, executive leadership, and marketing to the board. Plugues has been an ABTA donor since April 2001, following her father’s passing from GBM. She is also a former member of the ABTA endurance program, Team Breakthrough.

Bob Kruchten

Member

Bob Kruchten, of Mount Prospect, IL, is a sales manager at Extreme Reach, a leading advertising technology company. He has strong skills in communications and fundraising, and has been advocating for the ABTA for 19 years in tribute to his best friend, Paul Fabbri, who lost his 10-year battle with GBM in 1998. Kruchten accepted the ABTA’s Joel A. Gingras Jr. Award in 2015 on behalf of the Paul Fabbri Memorial Fund.