Dr Sudhir Kumar

Senior Consultant Neurologist

Apollo Hospitals, Hyderabad

every year is celebrated as “World brain tumor day” to raise awareness about the symptoms, diagnosis, and management of brain tumors. I would like to focus on the symptoms, presence of which, can make one suspect the presence of brain tumor.

Common symptoms of brain tumor include headache, vomiting, reduced alertness, fits, and paralysis. However, in several cases, these classical symptoms may be missing. It is important to know the lesser-known symptoms of brain tumors so that they can be diagnosed and treated at the earliest.

1. Increase in hat and shoe size over time- A tumor of pituitary gland of brain producing excess growth hormone causes a condition known as acromegaly, which can result in increasing head and feet size, necessitating a need for larger hats and bigger shoes.
2. Milk production from breasts (in a woman who is neither breastfeeding nor pregnant)- This condition is called galactorrhea and is caused by a tumor of pituitary gland, that produces excess prolactin hormone. In addition to milk discharge from nipples, these women can also have amenorrhea (absence of or irregular periods).
3. Loss of vision- Vision loss or blurred vision can occur in brain tumors. The extent and severity of vision loss depends on the location and size of brain tumor. Loss of vision can be on the sides of visual fields, or in one half of the visual field.
4. Loss of smell- Tumors arising in the frontal lobe of brain near olfactory nerve origin can cause loss of smell.
5. Impaired hearing- tumors located in cerebello-pontine angle (in the vicinity of auditory nerve) can cause hearing impairment and tinnitus.
6. Depressive symptoms- Patients with tumors of frontal lobe of brain can present solely with features of depression. In a patient with depression, who is aged 50 or more, or if depression is not responding to medical treatment, one should suspect a brain tumor.
7. Personality changes such as disinhibition (socially inappropriate behavior), agitation and mood swings can also be the presenting features of brain tumor.
8. Rapidly progressive dementia- Memory impairment along with dysfunction of other higher cognitive functions, which are rapidly deteriorating over weeks to months, could signal the presence of an underlying cancerous brain tumor.
9. Disease in a body part other than brain- Certain cancers in various parts of body can spread to the brain, called as metastases. For example, a person with cough or blood in sputum along with headache could have lung cancer with spread to the brain. Similarly, a woman with breast lump and disorientation could have a breast cancer with spread to the brain.
10. No symptoms- Yes, you heard it right. In many situations, one may not have any symptoms and still harbor a brain tumor. This is more likely if the tumor size is very small. In 7 out of 1000 people, in whom brain scan is done for other purposes (head injury or headache), a brain tumor is detected. In most such cases, surgery is not needed and follow up brain scans may be needed after 6 months or one year.