Ricker Polsdorfer, MD
When you appear with symptoms suggesting a
brain tumor, the first step will be a complete investigation of those symptoms and your overall health. The doctor will then perform a physical examination, with particular attention to the neurologic exam. A neurologic exam tests muscle strength, coordination, reflexes, response to stimuli, your senses, thought processes (including memory, general knowledge of events of which you will probably by familiar, as well as other abilities), and alertness. The doctor may also look into your eyes to check for signs of brain swelling that can be seen by looking at your retina.
At this point, your doctor will either conduct further tests or refer you to a neurologist or neurosurgeon.
Tests may include:
Sometimes tests are combined. For instance, certain contrast agents can be injected into the bloodstream that will produce better images with CT or MRI scanning, thus combining angiography with computerized imaging.
An example of this test is a CTA (CT angiogram) or MRA (magnetic resonance angiogram).
Some important characteristics of a tumor are:
These factors determine the symptoms, prognosis, and treatment. It is important whether the tumor originated in the nervous system or spread there from somewhere else in the body.
Tumors are graded according to numerous features. All cancers are graded to identify the most promising treatment and to determine their prognosis. In some cases, a biopsy cannot be safely performed. The doctors then estimate what type of brain tumor exists and make treatment plans accordingly.
Malignant brain tumors are graded on a numerical scale using one of several systems. The preferred grading system is the World Health Organization’s (WHO). The tumor grades help predict the rate of tumor growth, its ability to spread, and in turn prognosis. Astrocytomas are graded on a scale of I through IV as follows:
The two most important factors that predict how well someone may do are the patient’s age and performance status. Younger patients generally do better, as do patients who have very few symptoms associated with their tumor. Doctors always consider a patient’s age and performance status when they plan treatment.
Brain tumor. National Cancer Institute website. Available at:
http://www.cancer.gov/cancertopics/types/brain. Accessed August 21, 2012.
Brain tumor. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed/what.php. Updated July 18, 2012. Accessed August 21, 2012.
Harrison TR, Fauci AS.
Harrison's Principles of Internal Medicine.
14th ed. New York, NY: McGraw-Hill; 1998.
Louis DN, Ohgaki H, Wiestler OD, Cavanee WK.
WHO Classification of Tumors of the Central Nervous System.
4th ed. Lyon, France: International Agency for Research on Cancer; 2007.
Last reviewed October 2012 by Mohei Abouzied, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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