Intracranial tumor signs and symptoms

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Intracranial Tumor Signs and Symptoms

Common Symptoms of Intracranial Tumors

Intracranial tumors often present with a variety of symptoms, which can vary based on the tumor's location, size, and the patient's age. The most frequently reported symptoms include headaches, nausea, vomiting, and abnormalities in gait and coordination. Headaches are particularly common, occurring in about 33% of cases, and are often accompanied by nausea and vomiting in 32% of patients. These symptoms are indicative of raised intracranial pressure (ICP), a common consequence of intracranial tumors.

Age-Specific Symptoms

Children Under 4 Years

In children under the age of four, the symptoms can be slightly different. Macrocephaly, or an abnormally large head, is a significant indicator, occurring in 41% of cases. Other common symptoms in this age group include nausea and vomiting (30%), irritability (24%), and lethargy (21%). These symptoms often lead to a delay in diagnosis as they can mimic other common pediatric conditions such as meningitis.

Older Children and Young Adults

For older children and young adults, the symptoms evolve with age. Visual disturbances are more common in younger children, while headaches become more prevalent in older children and young adults. For instance, headaches are reported in 0.64 per 100 person-months in 5 to 11-year-olds, increasing to 2.44 per 100 person-months in 19 to 24-year-olds.

Location-Specific Symptoms

Posterior Fossa Tumors

Tumors located in the posterior fossa, which is a common site for pediatric brain tumors, often present with symptoms of intracranial hypertension due to obstruction of cerebrospinal fluid flow. These symptoms include nausea, vomiting, headaches, and ataxia (loss of coordination).

Supratentorial Tumors

Supratentorial tumors, located above the tentorium cerebelli, often present with non-localizing symptoms such as seizures, which occur in 38% of cases, and signs of raised ICP, which are present in 47% of cases. These tumors can also cause focal neurological deficits depending on their exact location within the brain.

Brainstem Tumors

Brainstem tumors are particularly challenging due to their critical location. Symptoms often include abnormalities in gait and coordination (78%), cranial nerve palsies (52%), and pyramidal signs (33%). These symptoms can significantly impact the patient's motor functions and overall quality of life.

Visual and Neurological Symptoms

Visual disturbances are a common early sign of intracranial tumors, especially those affecting the optic pathways. These can include transient visual obscurations, visual loss, or visual field defects. In some cases, optic disc abnormalities such as paleness, atrophy, or edema are observed. Neurological symptoms can also include cognitive impairments, personality changes, and seizures, which are particularly common in elderly patients.

Conclusion

Intracranial tumors present with a wide range of symptoms that vary based on the patient's age and the tumor's location. Common symptoms include headaches, nausea, vomiting, and visual disturbances. Age-specific symptoms such as macrocephaly in young children and headaches in older children and young adults are critical for early diagnosis. Location-specific symptoms provide further clues, with posterior fossa tumors often causing intracranial hypertension and brainstem tumors leading to significant motor deficits. Recognizing these symptoms early and conducting appropriate neuroimaging can aid in timely diagnosis and treatment, improving patient outcomes.