Brain Tumors

That said, symptoms you might notice if you or someone you know has a brain tumor can include:

• New onset or change in the pattern of headaches: These include headaches that aren’t improving with typical headache remedies, or you’re experiencing them more often, or they’re growing in intensity or worsening with activity.
• New onset of seizures: A brain tumor can cause seizures because it disrupts the brain’s regular electrical activity. Seizures can range from muscle jerks and spasms to a loss of consciousness and body functions. Changes in vision, smell, or sensation without losing consciousness can also denote a seizure.
• Difficulty with balance: The cerebellum is a portion of the brain in the back of the head that controls motor functions like balance for walking or standing. A tumor here can cause problems with these functions.
• Difficulty speaking or confusion: This can look like a change in speech, hearing, or memory, like problems understanding or retrieving words.
• Gradual loss of sensation or movement in an arm or a leg: This gradual loss of sensation or movement in the body happens when a tumor affects areas of the brain in charge of motor functions.
• Unexplained nausea or vomiting: Increased pressure inside the skull from the tumor can result in nausea and vomiting.
• Personality or behavior changes: These can manifest as new or unusual emotional states, such as changes in judgment, aggressiveness, loss of initiative, and even sluggishness. Depression and anxiety, mainly if either develops suddenly, can be an early symptom of a tumor in the brain.
• Blurred vision, double vision, or loss of peripheral vision: Vision changes, such as partial vision loss or even double vision, can result from a tumor in the temporal lobe, occipital lobe, or brain stem.
• Hearing problems: A brain tumor can exert pressure on nearby auditory pathways or influence the structures involved in auditory information processing.
• Fatigue or drowsiness: Brain tumors interfere with normal brain functions, including those regulating wakefulness. They can also cause an increase in the pressure in the skull, which leads to symptoms like fatigue, drowsiness, and lethargy.

If you’re concerned about experiencing new or persistent symptoms that align with these descriptions, it’s critical you talk to your healthcare provider as soon as possible.

Brain Tumor Diagnosis

Multiple steps are involved in accurately diagnosing the tumor’s location, type, and extent.

Your doctor might recommend the following exams and imaging tests to diagnose a brain tumor:

• Physical and neurological exam: First, your healthcare provider will ask about your symptoms, overall health, and family history of brain tumors or genetic conditions. Next, they’ll complete a neurological examination to assess neurological function, including reflexes, coordination, strength, and sensation.
• Magnetic Resonance Imaging (MRI): Imaging studies are crucial in visualizing the brain and identifying abnormalities. An MRI provides detailed brain images and can help determine a tumor’s location, size, and characteristics.
• Computed Tomography (CT): CT scans rely on X-rays to create detailed cross-sectional images of the brain and can help detect tumors while evaluating their size and location.
• Positron Emission Tomography (PET) scan: PET scans can evaluate the metabolic activity of brain tumors and determine their aggressiveness. Instead of only mapping brain infrastructure, a PET scan shows how your brain works.
• CT Angiography (CTA) and Magnetic Resonance Angiography (MRA): These scans, often completed with a contrast dye, locate blood vessels in the brain that can help your neurosurgeon better plan for removal.
• Biopsy: A biopsy establishes an exact tumor diagnosis by removing a small tissue sample from the tumor surgically or through stereotactic biopsy. Specialized neuropathologists examine the tissue under a microscope to determine the type of cells present, whether they’re cancerous or noncancerous, and other important characteristics that guide treatment decisions.

Additional tests, like cognitive or visual field testing, may be done to evaluate the tumor’s impact on overall brain function. Your doctor might also schedule you for electroencephalography (EEG) to assess the electrical activity in the brain to determine seizure risk.

Finally, genetic testing of tumor tissue can identify genetic mutations or alterations that can help predict the tumor’s behavior and response to treatment and identify people who can participate in personalized clinical trials based on unique tumor genetics. At Barrow Neurological Institute, our Ivy Brain Tumor Center can help oversee more detailed testing to identify a patient’s brain tumor subtype. This additional information helps our neurosurgeons, radiation oncologists, and neuro-oncologists to be even more precise in selecting treatments and clinical trials.

Brain Tumor Treatment

As with all other facets of a brain tumor, optimal treatment depends on the brain tumor’s type, location, size, growth rate, and your overall health. There is no single treatment that works best—each brain tumor is as unique as the person diagnosed with one. Often, a combination of treatments is used, and personalized approaches, like tumor profiling to look for specific gene mutations, can help determine the best treatments.

Optimal tumor treatment will involve a collaborative approach between neurosurgeons, neuro-oncologists, medical oncologists, radiation oncologists, and other specialists who work together to achieve the best possible outcome.

The following are some of the general approaches used for brain tumor surgery:

• Craniotomy: A craniotomy is the most common surgery for a brain tumor. During a craniotomy, a neurosurgeon will make an incision in the scalp, remove a portion of the skull, and access the brain to remove the tumor. Neurosurgeons use intraoperative imaging and highly specialized tools to visualize tumor tissue and remove it safely.
• Awake Craniotomy: Awake brain surgery, or awake craniotomy, is a specialized surgery for brain tumors in areas that control critical functions, like speech or movement. During awake brain surgery, you will be awake and alert while your surgeon removes the tumor, allowing the surgical team to monitor brain function in real-time and avoid damaging critical anatomy.
• Minimally invasive techniques: In some cases, your neurosurgeon might suggest minimally invasive surgical techniques to remove brain tumors. Minimally invasive brain tumor surgery uses smaller incisions and specialized instruments to access and remove the tumor, like endoscopic surgery and laser interstitial thermal therapy (LITT). These techniques can offer shorter recovery times, reduced risk of complications, and more minor scars.

Chemotherapy, Targeted Therapy, and Immunotherapy

Your oncology treatment team might recommend using these treatments on their own or in conjunction with surgery and radiation therapy:

• Chemotherapy: Your oncologist can give chemotherapy drugs orally or intravenously to inhibit the growth of cancer cells, but it can be challenging for them to reach the brain due to the blood-brain barrier, which acts as a shield against chemotherapy drugs. For this reason, chemotherapy drugs are sometimes administered intrathecally, meaning they are injected directly into the cerebrospinal fluid (CSF). Chemotherapy is often combined with surgery or radiation therapy, especially with tumors that are difficult to remove surgically.
• Targeted Therapy: Targeted therapy uses compounds to target specific molecules vital to cancer cells’ metabolism and reproduction.
• Immunotherapy: Immunotherapy works via a series of drugs that boost the body’s immune system to recognize and attack cancer cells.

Supportive care is also essential to brain tumor treatment. It can look like medications to manage symptoms like pain, seizures, and swelling in the brain, as well as access to physical and occupational therapy as well as counseling for patients and their families.

Clinical Trials

Many clinical trials evaluating potential drugs for treating brain tumors are ongoing. Though the treatments are experimental and not yet FDA-approved, clinical trials can be the best option for those with difficult-to-treat tumors to improve the odds of finding an effective treatment for them and for future patients.

As home to the Ivy Brain Tumor Center, Barrow Neurological Institute is proud to be one of the country’s largest sites for brain tumor clinical trials. 

Neuro-Rehabilitation for Quality of Life

At Barrow Neurological Institute, we give our patients access to various neuro-rehabilitation specialists to maximize independence. Neuro-rehabilitation can include physical therapy to help you regain strength and balance, speech therapy to support speaking, expressing thoughts, or swallowing, and occupational therapy to aid you in managing daily activities like bathing, dressing, and using the bathroom. Treating a brain tumor is about more than extending your life—it’s also equally focused on enhancing your quality of life.

One Central Location with Multiple Treatment Options

At Barrow Neurological Institute’s world-class Brain and Spine Tumor Program, we treat people with complex tumors in one robust, full-service location. Our sophisticated multidisciplinary team—neurosurgeons, head and neck surgeons, neuropathologists, neuro-oncologists, medical oncologists, and radiation oncologists, to name a few—can offer patients the latest treatments for head and neck cancers, including neurological and metastatic cancers.

Finally, we also offer a Brain Cancer Survivorship Program to foster relationships between families affected by brain tumors and provide ongoing support.