How are brain tumors diagnosed?
Brain tumors are diagnosed through a combination of physical exam and diagnostic tests. A neurological exam assesses both a patient’s physical condition?balance, sensory abilities, and muscle movement, for example?and his or her mental status. Next, images of the brain are captured by scanning techniques such as magnetic resonance imaging (MRI) or computed tomography (CT). In some cases, a physician may order a cerebral angiography, which is an X-ray of the brain’s blood vessels. • More from Anatomy of the Brain: The Brain Tumor Program at University …
Brain tumors are often difficult to diagnose because their signs and symptoms may mimic those of other disorders. Symptoms will also vary according to the exact location of the tumor. For example, many childhood brain tumors cause vomiting. However, there are other much more likely causes of vomiting. It is therefore not unusual that a child with vomiting is seen by a gastroenterologist before the proper diagnosis is made. Parents (and pediatricians) often feel distraught that they did not make the diagnosis earlier, but hindsight is always 20/20. Most of the time, the relatively short delay in diagnosis is of no significance in terms of outcome. You probably helped make your child’s diagnosis when you brought him or her to the doctor in response to some early signs of trouble. Many early signs are due to the effects of raised intracranial pressure (ICP), brought on by the tumor’s size or location, blocking the normal flow of cerebrospinal fluid (CSF) from the brain. If the tumor has b
Quite often it is not a headache that leads to the diagnosis of a brain tumor. Depending on the location of the tumor, it may take months or even years for the lesion to increase in size sufficiently to produce symptoms. Some tumors are discovered accidentally, such as during routine screening for migraines or following a minor head trauma, though this is very uncommon. Frequently patients with brain tumors seek evaluation by a physician because of other symptoms. For example, they may suddenly or gradually develop visual disturbances, weakness on one side of their body, slurred speech, hearing loss, ringing in the ears, imbalance, dizziness, memory and/or cognitive problems, seizures, or even incontinence. An abnormal neurological examination is the most worrisome predictor of structural brain lesion.
If a person has symptoms that suggest a brain tumor, the doctor may perform one or more of the following procedures: • Physical exam – The doctor checks general signs of health. • Neurologic exam – The doctor checks for alertness, muscle strength, coordination, reflexes, and response to pain. The doctor also examines the eyes to look for swelling caused by a tumor pressing on the nerve that connects the eye and brain. • CT scan – An x-ray machine linked to a computer takes a series of detailed pictures of the head. The patient may receive an injection of a special dye so the brain shows up clearly in the pictures. The pictures can show tumors in the brain. • MRI – A powerful magnet linked to a computer makes detailed pictures of areas inside the body. These pictures are viewed on a monitor and can also be printed. Sometimes a special dye is injected to help show differences in the tissues of the brain. The pictures can show a tumor or other problem in the brain. The doctor may ask for
INTRODUCTION The diagnosis of a brain tumor begins in the doctor’s office. The doctor begins by asking the patient a number of questions to get a complete history of the symptoms. Then he or she will do a basic neurological examination. NEUROLOGICAL EXAMINATION A basic neurological examination includes the following: • Eye movement, pupil reaction, and eye reflex tests • Hearing tests using a ticking watch or tuning fork • Reflex tests using a rubber hammer • Balance and coordination tests. Heel-to-toe walking. Heel-to-shin movements. Balance with feet together and eyes closed. Rapid alternating movements such as touching the finger to the nose with eyes closed. • Sense of touch tests using a pin point and cotton ball • Sense of smell tests using various odors • Facial muscle tests–smiling, grimacing • Tongue movement, gag reflex tests • Head movement tests • Mental status tests. Asking for the current time and date. Asking who is President. • Abstract thinking test. Asking for the me
