Brain Cancers; Brain Neoplasms; Intracranial Neoplasms, Adult Central Nervous System Tumors Treatment
A brain tumor is a growth of abnormal cells in the brain tissue that can be benign or malignant. Some are primary brain tumors, which start in the brain. Others are metastatic, and they start somewhere else in the body and move to the brain. Learn about the different types of brain tumors, common symptoms, and treatment options.
Brain Cancer Regions
Image by BruceBlaus
Brain Tumors
Brain MRI - bright blue color where brain cancer metastasizes in the occipital lobe
Image by Dr. Leon Kaufman. University Of California, San Francisco, NCI/NIH
Brain MRI - bright blue color where brain cancer metastasizes in the occipital lobe
A single image of a human brain using a magnetic resonance imaging (MRI) machine. A bright blue color where brain cancer metastasizes in the occipital lobe.
Image by Dr. Leon Kaufman. University Of California, San Francisco, NCI/NIH
Brain Tumors
A brain tumor is a growth of abnormal cells in the tissues of the brain. Brain tumors can be benign, with no cancer cells, or malignant, with cancer cells that grow quickly. Some are primary brain tumors, which start in the brain. Others are metastatic, and they start somewhere else in the body and move to the brain.
Brain tumors can cause many symptoms. Some of the most common are:
Headaches, often in the morning
Nausea and vomiting
Changes in your ability to talk, hear, or see
Problems with balance or walking
Problems with thinking or memory
Feeling weak or sleepy
Changes in your mood or behavior
Seizures
Doctors diagnose brain tumors by doing a neurologic exam and tests including an MRI, CT scan, and biopsy. Treatment options include watchful waiting, surgery, radiation therapy, chemotherapy, and targeted therapy. Targeted therapy uses drugs or other substances that attack cancer cells with less harm to normal cells. Many people get a combination of treatments.
Source: NIH: National Cancer Institute
Additional Materials (24)
Brain Cancer Regions
Brain Cancer Regions
Image by BruceBlaus
Killing Cancer - New Brain Cancer Treatment Targets Tumors
Video by National Science Foundation/YouTube
Having Radiotherapy for Brain Cancer
Video by Cancer Research UK/YouTube
Brain stem glioma
Video by ABC2 (Accelerate Brain Cancer Cure)/YouTube
Defining the Future of Brain Tumor Treatment | Nathan's Story
Video by NationwideChildrens/YouTube
Boy With Rare Brain Cancer Fights Impossible Odds
Video by ABC News/YouTube
Chemo Brain Cancer Treatment Side Effects
Video by Oncology Associates/YouTube
We Love Isaiah - Little boy battles brain cancer. And wins.
Video by ArnoldPalmerHospital/YouTube
Adult Brain and Spine Tumor Research and Treatment
Video by National Cancer Institute/YouTube
Updated Video Available: Keyhole Brain Tumor and Skull Base Surgery
Video by Pacific Neuroscience Institute/YouTube
Brain Tumors in Children | Accelerating Treatment Worldwide
Video by NationwideChildrens/YouTube
Why Cancers Spread to the Brain
Video by Lee Health/YouTube
Distinguishing Brain Tumors
Video by Lee Health/YouTube
Brain Tumor Diagnosis – Personalized Medicine for Gliomas
Video by Mayo Clinic/YouTube
Brain Tumors: Frequently Asked Questions | Jon Weingart, M.D.
Video by Johns Hopkins Medicine/YouTube
Radiation Oncology for Primary Brain Tumors – What You Need to Know
Video by Johns Hopkins Medicine/YouTube
Rush Radiosurgery: Head and Neck Cancer Radiation
Video by Rush Radiosurgery/YouTube
Young Miracle Cancer Survivor's Journey
Video by ABC News/YouTube
Pediatric Brain & Spinal Cord Tumors: Ask The Expert featuring Dr. Jason Fangusaro, Lurie Children's
Video by Ann & Robert H. Lurie Children's Hospital of Chicago/YouTube
What to know about a brain tumor diagnosis
Video by Mayo Clinic/YouTube
Brain Tumors and Second Opinions
Video by Johns Hopkins Medicine/YouTube
Atypical teratoid rhabdoid tumor (AT/RT) | Dana-Farber Cancer Institute
Video by Dana-Farber Cancer Institute/YouTube
TFRI Medulloblastoma program
Video by Terry Fox Research Institute/YouTube
Poliovirus Vaccine Trial Shows Promise for Recurrent Glioblastoma
Video by Duke Health/YouTube
Brain Cancer Regions
BruceBlaus
4:46
Killing Cancer - New Brain Cancer Treatment Targets Tumors
National Science Foundation/YouTube
1:18
Having Radiotherapy for Brain Cancer
Cancer Research UK/YouTube
2:08
Brain stem glioma
ABC2 (Accelerate Brain Cancer Cure)/YouTube
2:49
Defining the Future of Brain Tumor Treatment | Nathan's Story
NationwideChildrens/YouTube
9:19
Boy With Rare Brain Cancer Fights Impossible Odds
ABC News/YouTube
2:24
Chemo Brain Cancer Treatment Side Effects
Oncology Associates/YouTube
11:21
We Love Isaiah - Little boy battles brain cancer. And wins.
ArnoldPalmerHospital/YouTube
56:57
Adult Brain and Spine Tumor Research and Treatment
National Cancer Institute/YouTube
2:58
Updated Video Available: Keyhole Brain Tumor and Skull Base Surgery
Pacific Neuroscience Institute/YouTube
1:22
Brain Tumors in Children | Accelerating Treatment Worldwide
NationwideChildrens/YouTube
2:01
Why Cancers Spread to the Brain
Lee Health/YouTube
1:49
Distinguishing Brain Tumors
Lee Health/YouTube
6:21
Brain Tumor Diagnosis – Personalized Medicine for Gliomas
Mayo Clinic/YouTube
10:49
Brain Tumors: Frequently Asked Questions | Jon Weingart, M.D.
Johns Hopkins Medicine/YouTube
11:09
Radiation Oncology for Primary Brain Tumors – What You Need to Know
Johns Hopkins Medicine/YouTube
1:13
Rush Radiosurgery: Head and Neck Cancer Radiation
Rush Radiosurgery/YouTube
5:53
Young Miracle Cancer Survivor's Journey
ABC News/YouTube
4:30
Pediatric Brain & Spinal Cord Tumors: Ask The Expert featuring Dr. Jason Fangusaro, Lurie Children's
Ann & Robert H. Lurie Children's Hospital of Chicago/YouTube
1:43
What to know about a brain tumor diagnosis
Mayo Clinic/YouTube
1:09
Brain Tumors and Second Opinions
Johns Hopkins Medicine/YouTube
1:10
Atypical teratoid rhabdoid tumor (AT/RT) | Dana-Farber Cancer Institute
Dana-Farber Cancer Institute/YouTube
5:33
TFRI Medulloblastoma program
Terry Fox Research Institute/YouTube
2:56
Poliovirus Vaccine Trial Shows Promise for Recurrent Glioblastoma
Duke Health/YouTube
Adult Central Nervous System Tumors
Tumor PrimaryCNSLymphoma T1Saggital
Image by I, Tdvorak/Wikimedia
Tumor PrimaryCNSLymphoma T1Saggital
Primary CNS Lymphoma, MRI, T1 Saggital
Image by I, Tdvorak/Wikimedia
Adult Central Nervous System Tumors Treatment - Overview
General Information About Adult Central Nervous System Tumors
KEY POINTS
An adult central nervous system tumor is a disease in which abnormal cells form in the tissues of the brain and/or spinal cord.
A tumor that starts in another part of the body and spreads to the brain is called a metastatic brain tumor.
The brain controls many important body functions.
The spinal cord connects the brain to nerves in most parts of the body.
There are different types of brain and spinal cord tumors.
Astrocytic Tumors
Oligodendroglial Tumors
Mixed Gliomas
Ependymal Tumors
Medulloblastomas
Pineal Parenchymal Tumors
Meningeal Tumors
Germ Cell Tumors
Craniopharyngioma (Grade I)
Having certain genetic syndromes may increase the risk of a central nervous system tumor.
The cause of most adult brain and spinal cord tumors is not known.
The signs and symptoms of adult brain and spinal cord tumors are not the same in every person.
Tests that examine the brain and spinal cord are used to diagnose adult brain and spinal cord tumors.
A biopsy is also used to diagnose a brain tumor.
Sometimes a biopsy or surgery cannot be done.
Certain factors affect prognosis (chance of recovery) and treatment options.
An adult central nervous system tumor is a disease in which abnormal cells form in the tissues of the brain and/or spinal cord.
There are many types of brain and spinal cord tumors. The tumors are formed by the abnormal growth of cells and may begin in different parts of the brain or spinal cord. Together, the brain and spinal cord make up the central nervous system (CNS).
The tumors may be either benign (not cancer) or malignant (cancer):
Benign brain and spinal cord tumors grow and press on nearby areas of the brain. They rarely spread into other tissues and may recur (come back).
Malignant brain and spinal cord tumors are likely to grow quickly and spread into other brain tissue.
When a tumor grows into or presses on an area of the brain, it may stop that part of the brain from working the way it should. Both benign and malignant brain tumors cause signs and symptoms and need treatment.
Brain and spinal cord tumors can occur in both adults and children. However, treatment for children may be different than treatment for adults.
A tumor that starts in another part of the body and spreads to the brain is called a metastatic brain tumor.
Tumors that start in the brain are called primary brain tumors. Primary brain tumors may spread to other parts of the brain or to the spine. They rarely spread to other parts of the body.
Often, tumors found in the brain have started somewhere else in the body and spread to one or more parts of the brain. These are called metastatic brain tumors (or brain metastases). Metastatic brain tumors are more common than primary brain tumors.
Up to half of metastatic brain tumors are from lung cancer. Other types of cancer that commonly spread to the brain include:
Melanoma.
Breast cancer.
Colon cancer.
Kidney cancer.
Nasopharyngeal cancer.
Cancer of unknown primary site.
Cancer may spread to the leptomeninges (the two innermost membranes covering the brain and spinal cord). This is called leptomeningeal carcinomatosis. The most common cancers that spread to the leptomeninges include:
Breast cancer.
Lung cancer.
Leukemia.
Lymphoma.
See the following for more information about cancers that commonly spread to the brain or spinal cord
The brain controls many important body functions.
The brain has three major parts:
The cerebrum is the largest part of the brain. It is at the top of the head. The cerebrum controls thinking, learning, problem solving, emotions, speech, reading, writing, and voluntary movement.
The cerebellum is in the lower back of the brain (near the middle of the back of the head). It controls movement, balance, and posture.
The brain stem connects the brain to the spinal cord. It is in the lowest part of the brain (just above the back of the neck). The brain stem controls breathing, heart rate, and the nerves and muscles used to see, hear, walk, talk, and eat.
The spinal cord connects the brain to nerves in most parts of the body.
The spinal cord is a column of nerve tissue that runs from the brain stem down the center of the back. It is covered by three thin layers of tissue called membranes. These membranes are surrounded by the vertebrae (back bones). Spinal cord nerves carry messages between the brain and the rest of the body, such as a message from the brain to cause muscles to move or a message from the skin to the brain to feel touch.
Source: National Cancer Institute (NCI)
Spotlight
Glioblastoma
Image by Llorenzi
Glioblastoma
Image Animation: Animated gif of CT scan sequenced axially of brain with a glioblastoma
Image by Llorenzi
Spotlight on Brain Tumors: Do You Know the Symptoms?
A tumor in the brain isn’t like tumors in other parts of your body. It has limited room for growth because of the skull. This means that a growing tumor can squeeze vital parts of the brain and lead to serious health problems. Learning about the possible symptoms of brain tumors can help you know when to tell a doctor about them.
A tumor is an abnormal mass of cells. When most normal cells grow old or get damaged, they die, and new cells take their place. Sometimes, this process goes wrong. New cells form when the body doesn’t need them, and old or damaged cells don’t die as they should. The extra cells can form a tumor.
A tumor that starts in the brain is called a primary brain tumor. People of all ages can develop this type of tumor, even children. And there are many different ways they can form.
“There are over 130 different types of primary brain tumors,” says Dr. Mark R. Gilbert, an NIH brain tumor expert. About 80,000 people in the U.S. are diagnosed with a primary brain tumor each year.
Cancer that has spread to the brain from another part of the body is called a metastatic brain tumor. Metastatic brain tumors are far more common than primary tumors.
Both primary and metastatic brain tumors can cause similar symptoms. Symptoms depend mainly on where the tumor is in the brain.
“The symptoms of brain tumors can be either dramatic or subtle,” Gilbert says. A seizure is an example of a dramatic symptom. About 3 of every 10 patients with a brain tumor are diagnosed after having a seizure, he explains.
Other symptoms are less obvious. For example, you might notice memory problems or weakness on one side of your body. Until symptoms develop, you may not know you have a brain tumor. For a list of common symptoms of brain tumors, see the Wise Choices box.
If you have symptoms that suggest a brain tumor, tell your doctor. Your doctor will give you a physical exam and ask about your personal and family health history. You may need to have additional tests. Tumors can be detected by imaging methods such as MRI or CT scans.
“Brain imaging technology has really changed the way we are able to visualize abnormalities,” Gilbert explains. It allows brain surgeons to learn as much as possible about the tumor and remove it more safely.
NIH researchers are continuing to look for ways to better detect and treat brain tumors. Treatments differ depending on the type and location of the tumor. Treatment can involve surgery, radiation (beams of high energy rays aimed at the tumor), or drugs that kill or block the growth of cancer cells.
Usually, brain tumor treatment requires a team of health care professionals. This may include surgeons, cancer specialists, nutritionists, nurses, and mental health providers. The team does more than treat the tumor. They also try to minimize its impact on a patient’s quality of life.
“There is a definite advantage to being cared for by people who do this on a routine basis,” Gilbert says. A person who has been diagnosed with a brain tumor may want to seek treatment at a nearby cancer center, if possible.
Possible Symptoms of a Brain Tumor
The symptoms of a brain tumor depend on its size, type, and location. The most common ones are listed below. These do not mean you have a brain tumor. But talk with your doctor if you experience any of the following:
Severe headaches
Muscle jerking or twitching (seizures or convulsions)
Nausea and vomiting
Changes in speech, vision, or hearing
Problems balancing or walking
Changes in your mood, personality, or ability to concentrate
Problems with memory
Numbness, tingling, or weakness in the arms or legs
Source: NIH News in Health
Additional Materials (12)
Glioblastoma
Image Animation: Animated gif of CT scan sequenced coronally of brain with a glioblastoma
Image by Llorenzi
Glioblastoma
Image Animation: Animated gif of CT scan sequenced sagitally of brain with a glioblastoma
Image by Llorenzi
Medulloblastomas
CT scan, showing a tumorous mass in the posterior fossa, giving rise to obstructive hydrocephalus, in a six-year-old girl
Image by Reytan
Primitive neuroectodermal tumor
Supratentorial central PNET in a 5-year-old patient
Image by Paddy Mendez R.
Gliomatosis cerebri
Axial fluid-attenuated inversion recovery MRI image demonstrating tumor-related infiltration involving both temporal lobes (Short arrow), and the substantia nigra (Long arrow).
Image by Emmanuelle Duron, Anne Lazareth, Jean-yves Gaubert, Carole Raso, Olivier Hanon, Anne-sophie Rigaud
Brainstem glioma
Brain tumor - A brainstem glioma in four-year old. MRI sagittal, without contrast
Image by Tdvorak
Brain metastasis
Space-occupying lesion correlating with left temporo-parietal metastatic infiltration associated with peritumoral edema. Brain MRI, same lesion seen by CT scan:File:CT brain tumor.jpg.
Image by Bobjgalindo
PINEAL TUMOR
MRI of papillary tumor of the pineal region (PTPR) in an 18-year old boy. Sagittal T1+Gd. Image modified to obscure patient identity.
Image by Martin Hasselblatt MD
PET scans of brain tumor using Sigma-2 Ligands
This is a figure from a open-access research paper that shows several different brain imaging scans using unique sigma-2 receptor ligands. The scans are related to tumor growth and cancer progression over a 10 week period. The figure also includes MRI scans for comparison with PET scans.
Image by Shoghi KI, Xu J, Su Y, He J, Rowland D, et al.
TAC Brain tumor glioblastoma After 2 month of the operation-Transverse plane
Image by Llorenzi/Wikimedia
TAC Brain tumor glioblastoma After 2 month of the operation-Transverse plane
Glioblastoma dopo 2 mesi circa dalla sua rimozione
Image by Llorenzi/Wikimedia
There Are Different Types of Brain and Spinal Cord Tumors.
There are different types of brain and spinal cord tumors.
Brain and spinal cord tumors are named based on the type of cell they formed in and where the tumor first formed in the CNS. The grade of a tumor may be used to tell the difference between slow-growing and fast-growing types of the tumor. The World Health Organization (WHO) tumor grades are based on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread.
WHO Tumor Grading System
Grade I (low-grade) — The tumor cells look more like normal cells under a microscope and grow and spread more slowly than grade II, III, and IV tumor cells. They rarely spread into nearby tissues. Grade I brain tumors may be completely removed by surgery.
Grade II — The tumor cells grow and spread more slowly than grade III and IV tumor cells. They may spread into nearby tissue and may recur (come back). Some tumors may become a higher-grade tumor.
Grade III — The tumor cells look very different from normal cells under a microscope and grow more quickly than grade I and II tumor cells. They are likely to spread into nearby tissue.
Grade IV (high-grade) — The tumor cells do not look like normal cells under a microscope and grow and spread very quickly. There may be areas of dead cells in the tumor. Grade IV tumors usually cannot be completely removed by surgery.
The following types of primary tumors can form in the brain or spinal cord:
Astrocytic Tumors
An astrocytic tumor begins in star-shaped brain cells called astrocytes, which help keep nerve cells healthy. An astrocyte is a type of glial cell. Glial cells sometimes form tumors called gliomas. Astrocytic tumors include the following:
Brain stem glioma (usually high grade): A brain stem glioma forms in the brain stem, which is the part of the brain connected to the spinal cord. It is often a high-grade tumor, which spreads widely through the brain stem. Brain stem gliomas are rare in adults. (See the PDQ summary on Childhood Brain Stem Glioma Treatment for more information.)
Pineal astrocytic tumor (any grade): A pineal astrocytic tumor forms in tissue around the pineal gland and may be any grade. The pineal gland is a tiny organ in the brain that makes melatonin, a hormone that helps control the sleeping and waking cycle.
Pilocytic astrocytoma (grade I): A pilocytic astrocytoma grows slowly in the brain or spinal cord. It may be in the form of a cyst and rarely spreads into nearby tissues.
Diffuse astrocytoma (grade II): A diffuse astrocytoma grows slowly, but often spreads into nearby tissues. The tumor cells look something like normal cells. It is also called a low-grade diffuse astrocytoma.
Anaplastic astrocytoma (grade III): An anaplastic astrocytoma grows quickly and spreads into nearby tissues. The tumor cells look different from normal cells. An anaplastic astrocytoma is also called a malignant astrocytoma or high-grade astrocytoma.
Glioblastoma (grade IV): A glioblastoma grows and spreads very quickly. The tumor cells look very different from normal cells. It is also called glioblastoma multiforme.
Oligodendroglial Tumors
An oligodendroglial tumor begins in brain cells called oligodendrocytes, which help keep nerve cells healthy. An oligodendrocyte is a type of glial cell. Oligodendrocytes sometimes form tumors called oligodendrogliomas. Grades of oligodendroglial tumors include the following:
Oligodendroglioma (grade II): An oligodendroglioma grows slowly, but often spreads into nearby tissues. The tumor cells look something like normal cells.
Anaplastic oligodendroglioma (grade III): An anaplastic oligodendroglioma grows quickly and spreads into nearby tissues. The tumor cells look different from normal cells.
Mixed Gliomas
A mixed glioma is a brain tumor that has two types of tumor cells in it — oligodendrocytes and astrocytes. This type of mixed tumor is called an oligoastrocytoma.
Oligoastrocytoma (grade II): An oligoastrocytoma is a slow-growing tumor. The tumor cells look something like normal cells. .
Anaplastic oligoastrocytoma (grade III): An anaplastic oligoastrocytoma grows quickly and spreads into nearby tissues. The tumor cells look different from normal cells. This type of tumor has a worse prognosis than oligoastrocytoma (grade II).
Ependymal Tumors
An ependymal tumor usually begins in cells that line the fluid-filled spaces in the brain and around the spinal cord. An ependymal tumor may also be called an ependymoma. Grades of ependymomas include the following:
Ependymoma (grade I or II): A grade I or II ependymoma grows slowly and has cells that look something like normal cells. There are two types of grade I ependymoma — myxopapillary ependymoma and subependymoma. A grade II ependymoma grows in a ventricle (fluid-filled space in the brain) and its connecting paths or in the spinal cord.
Anaplastic ependymoma (grade III): An anaplastic ependymoma grows quickly and spreads into nearby tissues. The tumor cells look different from normal cells. This type of tumor usually has a worse prognosis than a grade I or II ependymoma.
Medulloblastomas
A medulloblastoma is a type of embryonal tumor. Medulloblastomas are most common in children or young adults.
Pineal Parenchymal Tumors
A pineal parenchymal tumor forms in parenchymal cells or pineocytes, which are the cells that make up most of the pineal gland. These tumors are different from pineal astrocytic tumors. Grades of pineal parenchymal tumors include the following:
Pineocytoma (grade II): A pineocytoma is a slow-growing pineal tumor.
Pineoblastoma (grade IV): A pineoblastoma is a rare tumor that is very likely to spread.
Meningeal Tumors
A meningeal tumor, also called a meningioma, forms in the meninges (thin layers of tissue that cover the brain and spinal cord). It can form from different types of brain or spinal cord cells. Meningiomas are most common in adults. Types of meningeal tumors include the following:
Meningioma (grade I): A grade I meningioma is the most common type of meningeal tumor. A grade I meningioma is a slow-growing tumor. It forms most often in the dura mater. A grade I meningioma may be completely removed by surgery.
Meningioma (grade II and III): This is a rare meningeal tumor. It grows quickly and is likely to spread within the brain and spinal cord. The prognosis is worse than a grade I meningioma because the tumor usually cannot be completely removed by surgery.
A hemangiopericytoma is not a meningeal tumor but is treated like a grade II or III meningioma. A hemangiopericytoma usually forms in the dura mater. The prognosis is worse than a grade I meningioma because the tumor usually cannot be completely removed by surgery.
Germ Cell Tumors
A germ cell tumor forms in germ cells, which are the cells that develop into sperm in men or ova (eggs) in women. There are different types of germ cell tumors. These include germinomas, teratomas, embryonal yolk sac carcinomas, and choriocarcinomas. Germ cell tumors can be either benign or malignant.
Craniopharyngioma (Grade I)
A craniopharyngioma is a rare tumor that usually forms in the center of the brain just above the pituitary gland (a pea-sized organ at the bottom of the brain that controls other glands). Craniopharyngiomas can form from different types of brain or spinal cord cells.
Source: National Cancer Institute (NIH)
Additional Materials (4)
TAC Brain tumor glioblastoma-Transverse plane
TAC_Brain_tumor_glioblastoma-Transverse_plane
Image by Llorenzi/Wikimedia
PET glioblastoma brain cancer
PET glioblastoma brain cancer
Image by Llorenzi/Wikimedia
2-Minute Neuroscience: Brain tumors
Video by Neuroscientifically Challenged/YouTube
Brain Tumor
Brain metastasis in the right cerebral hemisphere from lung cancer shown on magnetic resonance imaging.
Image by Marvin 101
TAC Brain tumor glioblastoma-Transverse plane
Llorenzi/Wikimedia
PET glioblastoma brain cancer
Llorenzi/Wikimedia
1:59
2-Minute Neuroscience: Brain tumors
Neuroscientifically Challenged/YouTube
Brain Tumor
Marvin 101
Genetic Syndromes
3D Monte Carlo Dose Calculation System Designed Specifically for Radiation Therapy Planning
Image by US Department of Energy
3D Monte Carlo Dose Calculation System Designed Specifically for Radiation Therapy Planning
GRAPHIC OF A SLICE OF 3D MONTE CARLO BASED PEREGRINE DOSE CALCULATION SUPERIMPOSED ON PATIENT'S CT IMAGE AND COLOR CODED. PEREGRINE IS A 3D MONTE CARLO DOSE CALCULATION SYSTEM DESIGNED SPECIFICALLY FOR RADIATION THERAPY PLANNING. PEREGRINE ACCURATELY MODELS THE RADIATION BEAM DELIVERY SYSTEM FOR EACH PLANNED TREATMENT AND USES EACH PATIENT'S CT SCAN FOR DETAILED INFORMATION ABOUT THE TUMOR AND SURROUNDING TISSUE.
Image by US Department of Energy
Having Certain Genetic Syndromes May Increase the Risk of a Central Nervous System Tumor.
Anything that increases your chance of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn’t mean that you will not get cancer. Talk with your doctor if you think you may be at risk. There are few known risk factors for brain tumors. The following conditions may increase the risk of certain types of brain tumors:
Being exposed to vinyl chloride may increase the risk of glioma.
Infection with the Epstein-Barr virus, having AIDS (acquired immunodeficiency syndrome), or receiving an organ transplant may increase the risk of primary CNS lymphoma. (See the PDQ summary on Primary CNS Lymphoma for more information.)
Having certain genetic syndromes may increase the risk brain tumors:
Neurofibromatosis type 1 (NF1) or 2 (NF2).
von Hippel-Lindau disease.
Tuberous sclerosis.
Li-Fraumeni syndrome.
Turcot syndrome type 1 or 2.
Nevoid basal cell carcinoma syndrome.
The cause of most adult brain and spinal cord tumors is not known.
Source: National Cancer Institute (NIH)
Additional Materials (6)
Radiation treatment
Capt. Candice Adams Ismirle waits to receive a radiation treatment Oct. 22, 2013, at Walter Reed National Military Medical Center in Bethesda, Md. After approximately two years in remission, Ismirle recently learned her cancer had returned.
Image by U.S. Air Force photo/Staff Sgt. Russ Scalf
Radiation therapy
Irradiation of nasopharyngeal carcinoma by photon (X-ray) therapy (left) and proton therapy (right)
Image by Taheri-Kadkhoda et al. Radiation Oncology
Warning Sign of Ionizing Radiation
Internationally recognized symbol. Warning sign of Ionizing Radiation.
Image by Cary Bass
EPA image - Penetrating Powers of Ionizing Radiation Image
EPA image - Penetrating Powers of Ionizing Radiation
Image by United States Environmental Protection Agency | US EPA/Wikimedia
Brain Tumour facts: 10 things you should know about brain tumours | Cancer Research UK
Video by Cancer Research UK/YouTube
Family history
Family
Image by Geralt
Radiation treatment
U.S. Air Force photo/Staff Sgt. Russ Scalf
Radiation therapy
Taheri-Kadkhoda et al. Radiation Oncology
Warning Sign of Ionizing Radiation
Cary Bass
EPA image - Penetrating Powers of Ionizing Radiation Image
United States Environmental Protection Agency | US EPA/Wikimedia
1:08
Brain Tumour facts: 10 things you should know about brain tumours | Cancer Research UK
Cancer Research UK/YouTube
Family history
Geralt
Symptoms
Depiction of a person suffering from a headache
Image by https://www.myupchar.com
Depiction of a person suffering from a headache
Depiction of a person suffering from a headache. The types of headaches have been mentioned.
Image by https://www.myupchar.com
The Signs and Symptoms of Adult Brain and Spinal Cord Tumors Are Not the Same in Every Person.
Signs and symptoms depend on the following:
Where the tumor forms in the brain or spinal cord.
What the affected part of the brain controls.
The size of the tumor.
Signs and symptoms may be caused by CNS tumors or by other conditions, including cancer that has spread to the brain. Check with your doctor if you have any of the following:
Brain Tumor Symptoms
Morning headache or headache that goes away after vomiting.
Seizures.
Vision, hearing, and speech problems.
Loss of appetite.
Frequent nausea and vomiting.
Changes in personality, mood, ability to focus, or behavior.
Loss of balance and trouble walking.
Weakness.
Unusual sleepiness or change in activity level.
Spinal Cord Tumor Symptoms
Back pain or pain that spreads from the back towards the arms or legs.
A change in bowel habits or trouble urinating.
Weakness or numbness in the arms or legs.
Trouble walking.
Source: National Cancer Institute (NIH)
Additional Materials (4)
Headache
Headache
Image by Injurymap
6 Warning Signs of Brain Tumors
Video by Cleveland Clinic/YouTube
Signs and Symptoms of a Brain Tumor | Dana-Farber Cancer Institute
Video by Dana-Farber Cancer Institute/YouTube
headache
migraine-headache-pain
Image by r. nial bradshaw
Headache
Injurymap
2:28
6 Warning Signs of Brain Tumors
Cleveland Clinic/YouTube
2:06
Signs and Symptoms of a Brain Tumor | Dana-Farber Cancer Institute
Dana-Farber Cancer Institute/YouTube
headache
r. nial bradshaw
Diagnosis
Right Side
Back Side
Left Side
1
2
3
Brain angiography with contrast
Interactive by TheVisualMD
Right Side
Back Side
Left Side
1
2
3
Brain angiography with contrast
Cerebral angiography is a procedure that uses a special dye (contrast material) and x-rays to see how blood flows through the brain. Doctors may order this test if symptoms or signs of vascular malformation (abnormal blood vessels), aneurysm (blood-filled dilation of a blood vessel), narrowing of the arteries in the brain, and vasculitis (inflammation of blood vessels) are present. Sometimes, it is also used to confirm a brain tumor, evaluate the arteries of the head and neck before surgery, and find a clot that may have caused a stroke.
Interactive by TheVisualMD
Tests That Examine the Brain and Spinal Cord Are Used to Diagnose Adult Brain and Spinal Cord Tumors.
The following tests and procedures may be used:
Physical exam and health history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
Neurological exam: A series of questions and tests to check the brain, spinal cord, and nerve function. The exam checks a person’s mental status, coordination, and ability to walk normally, and how well the muscles, senses, and reflexes work. This may also be called a neuro exam or a neurologic exam.
Visual field exam: An exam to check a person’s field of vision (the total area in which objects can be seen). This test measures both central vision (how much a person can see when looking straight ahead) and peripheral vision (how much a person can see in all other directions while staring straight ahead). Any loss of vision may be a sign of a tumor that has damaged or pressed on the parts of the brain that affect eyesight.
Tumor marker test: A procedure in which a sample of blood, urine, or tissue is checked to measure the amounts of certain substances made by organs, tissues, or tumor cells in the body. Certain substances are linked to specific types of cancer when found in increased levels in the body. These are called tumor markers. This test may be done to diagnose a germ cell tumor.
Gene testing: A laboratory test in which cells or tissue are analyzed to look for changes in genes or chromosomes. These changes may be a sign that a person has or is at risk of having a specific disease or condition.
CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
MRI (magnetic resonance imaging) with gadolinium: A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of the brain and spinal cord. A substance called gadolinium is injected into a vein. The gadolinium collects around the cancer cells so they show up brighter in the picture. This procedure is also called nuclear magnetic resonance imaging (NMRI). MRI is often used to diagnose tumors in the spinal cord. Sometimes a procedure called magnetic resonance spectroscopy (MRS) is done during the MRI scan. An MRS is used to diagnose tumors, based on their chemical make-up.
SPECT scan (single photon emission computed tomography scan): A procedure to find malignant tumor cells in the brain. A small amount of a radioactive substance is injected into a vein or inhaled through the nose. As the substance travels through the blood, a camera rotates around the head and takes pictures of the brain. A computer uses the pictures to make a 3-dimensional (3-D) image of the brain. There will be increased blood flow and more activity in areas where cancer cells are growing. These areas will show up brighter in the picture.
PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the brain. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do. PET is used to tell the difference between a primary tumor and a tumor that has spread to the brain from somewhere else in the body.
A biopsy is also used to diagnose a brain tumor.
If imaging tests show there may be a brain tumor, a biopsy is usually done. One of the following types of biopsies may be used:
Stereotactic biopsy: When imaging tests show there may be a tumor deep in the brain in a hard to reach place, a stereotactic brain biopsy may be done. This kind of biopsy uses a computer and a 3-dimensional (3-D) scanning device to find the tumor and guide the needle used to remove the tissue. A small incision is made in the scalp and a small hole is drilled through the skull. A biopsy needle is inserted through the hole to remove cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer.
Open biopsy: When imaging tests show that there may be a tumor that can be removed by surgery, an open biopsy may be done. A part of the skull is removed in an operation called a craniotomy. A sample of brain tissue is removed and viewed under a microscope by a pathologist. If cancer cells are found, some or all of the tumor may be removed during the same surgery. Tests are done before surgery to find the areas around the tumor that are important for normal brain function. There are also ways to test brain function during surgery. The doctor will use the results of these tests to remove as much of the tumor as possible with the least damage to normal tissue in the brain.
The pathologist checks the biopsy sample to find out the type and grade of brain tumor. The grade of the tumor is based on how the tumor cells look under a microscope and how quickly the tumor is likely to grow and spread.
The following tests may be done on the tumor tissue that is removed:
Immunohistochemistry: A laboratory test that uses antibodies to check for certain antigens (markers) in a sample of a patient’s tissue. The antibodies are usually linked to an enzyme or a fluorescent dye. After the antibodies bind to a specific antigen in the tissue sample, the enzyme or dye is activated, and the antigen can then be seen under a microscope. This type of test is used to help diagnose cancer and to help tell one type of cancer from another type of cancer.
Light and electron microscopy: A laboratory test in which cells in a sample of tissue are viewed under regular and high-powered microscopes to look for certain changes in the cells.
Cytogenetic analysis: A laboratory test in which the chromosomes of cells in a sample of brain tissue are counted and checked for any changes, such as broken, missing, rearranged, or extra chromosomes. Changes in certain chromosomes may be a sign of cancer. Cytogenetic analysis is used to help diagnose cancer, plan treatment, or find out how well treatment is working.
Sometimes a biopsy or surgery cannot be done.
For some tumors, a biopsy or surgery cannot be done safely because of where the tumor formed in the brain or spinal cord. These tumors are diagnosed and treated based on the results of imaging tests and other procedures.
Sometimes the results of imaging tests and other procedures show that the tumor is very likely to be benign and a biopsy is not done.
Certain factors affect prognosis (chance of recovery) and treatment options.
The prognosis and treatment options for primary brain and spinal cord tumors depend on the following:
The type and grade of the tumor.
Where the tumor is in the brain or spinal cord.
Whether the tumor can be removed by surgery.
Whether cancer cells remain after surgery.
Whether there are certain changes in the chromosomes.
Whether the cancer has just been diagnosed or has recurred (come back).
The patient's general health.
The prognosis and treatment options for metastatic brain and spinal cord tumors depend on the following:
Whether there are more than two tumors in the brain or spinal cord.
Where the tumor is in the brain or spinal cord.
How well the tumor responds to treatment.
Whether the primary tumor continues to grow or spread.
Source: National Cancer Institute (NIH)
Additional Materials (5)
Stereotactic brain biopsy
Simplistic representation of a stereotactic brain biopsy.
Image by SimplisticReps
Sensitive content
This media may include sensitive content
Brain Biopsy
Diagram showing a burr hole biopsy.
Image by Cancer Research UK / Wikimedia Commons
Sensitive content
This media may include sensitive content
CAT Scan
A computer-assisted tomographic (CAT) scanner, with a Caucasian female technician working at a screen and behind a glass wall. A patient is on a table and being tested by the CAT scanner. The lighting is very subdued. This new technology revolutionized detection of brain tumors.
Image by National Cancer Institute / Linda Bartlett (Photographer)
Brain Tumor Diagnosis and Treatment - Mayo Clinic
Video by Mayo Clinic/YouTube
MRI Scans
Brain MRI Vector representation.
Image by Nevit Dilmen (talk)
Stereotactic brain biopsy
SimplisticReps
Sensitive content
This media may include sensitive content
Brain Biopsy
Cancer Research UK / Wikimedia Commons
Sensitive content
This media may include sensitive content
CAT Scan
National Cancer Institute / Linda Bartlett (Photographer)
7:02
Brain Tumor Diagnosis and Treatment - Mayo Clinic
Mayo Clinic/YouTube
MRI Scans
Nevit Dilmen (talk)
Angiogram
Coronary Angiography
Also called: Cardiac Angiography
Coronary angiography is a procedure that uses contrast dye and x-ray pictures to look at the insides of your arteries. It can show whether plaque is blocking your arteries and how severe the blockage is. It is used to diagnose heart diseases after chest pain, sudden cardiac arrest (SCA), or abnormal results from other heart tests.
Coronary Angiography
Also called: Cardiac Angiography
Coronary angiography is a procedure that uses contrast dye and x-ray pictures to look at the insides of your arteries. It can show whether plaque is blocking your arteries and how severe the blockage is. It is used to diagnose heart diseases after chest pain, sudden cardiac arrest (SCA), or abnormal results from other heart tests.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
A normal coronary angiogram means that the heart and heart valves look normal. It also shows that the examined blood vessels look normal, blood flow is not reduced, and there is no narrowing, blockage, bulging (aneurysm), or large buildup of plaque.
Related conditions
Coronary angiography (angiogram) is a procedure that uses contrast dye and x-ray pictures to look at the insides of your arteries. It can show whether plaque is blocking your arteries and how severe the blockage is. Doctors use this procedure to diagnose heart diseases after chest pain, sudden cardiac arrest (SCA), or abnormal results from other heart tests such as an EKG or a stress test.
You usually have a cardiac catheterization to get the dye into your coronary arteries. Then you have special x-rays while the dye is flowing through your coronary arteries. The dye lets your doctor study the flow of blood through your heart and blood vessels.
This procedure is used to diagnose heart diseases or after abnormal results from tests such as an electrocardiogram (EKG) or an exercise stress test. If you are having a heart attack, coronary angiography can help your doctors plan your treatment.
Your doctor may recommend coronary angiography if you have signs or symptoms of coronary heart disease (CHD). Signs and symptoms include:
Angina. This is unexplained pain or pressure in your chest. You also may feel it in your shoulders, arms, neck, jaw, or back. The pain my even feel like indigestion. Angina may not only happen when you're active. Emotional stress also can trigger the pain associated with angina.
Sudden cardiac arrest (SCA). This is a condition in which your heart suddenly and unexpectedly stops beating.
Abnormal results from tests such as an EKG (electrocardiogram), exercise stress test, or other test.
Coronary angiography also might be done on an emergency basis, such as during a heart attack. If angiography shows blockages in your coronary arteries, your doctor may do a procedure called percutaneous coronary intervention, also known as angioplasty (AN-jee-oh-plas-tee). This procedure can open blocked heart arteries and prevent further heart damage.
Coronary angiography also can help your doctor plan treatment after you’ve had a heart attack, especially if you have major heart damage or if you’re still having chest pain.
Coronary angiography is often done in a hospital. You will stay awake, but receive medicine to relax during the procedure. Coronary angiography is done via a cardiac catheterization procedure. For this, your doctor will clean and numb an area on the arm, groin or upper thigh, or neck before making a small hole in the skin and a blood vessel. Your doctor will insert a catheter tube into your blood vessel. Your doctor will take X-ray pictures to help place the catheter in your coronary arteries. After the catheter is in place, your doctor will inject the contrast dye through the catheter to highlight blockages and will take X-ray pictures of your heart. If blockages are detected, your doctor may use percutaneous coronary intervention, also known as coronary balloon angioplasty, usually with the use of a stent (a wire mesh that helps keep an blocked artery open), to improve blood flow to your heart.
After coronary angiography, your doctor will remove the catheter and close and bandage the opening on your arm, groin, or neck. You may develop a bruise and soreness where the catheter was inserted. You will stay in the hospital for a few hours or sometimes overnight. During this time, your healthcare team will check your heart rate, blood pressure, and the catheter insertion site.
Before having coronary angiography, talk with your doctor about:
How the test is done and how to prepare for it
Any medicines you're taking, and whether you should stop taking them before the test
Whether you have diseases or conditions that may require taking extra steps during or after the test to avoid complications. Examples of such conditions include diabetes and kidney disease.
Coronary angiography is a common procedure that rarely causes serious problems. However, as with any invasive procedure involving the heart, there is some risk. These risks include bleeding, allergic reactions to the contrast dye, kidney problems, infection, blood vessel damage, arrhythmias, and blood clots that can trigger a heart attack or stroke. The risk of complications is higher in people who are older or who have chronic kidney disease or diabetes.
Your coronary angiography images will be studied by a radiologist, who will send your results to your provider.
https://medlineplus.gov/hearthealthtests.html [accessed on Feb 23, 2022]
https://www.nhlbi.nih.gov/health/heart-tests [accessed on Feb 23, 2022]
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Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (7)
Coronary angiography
Coronary angiography
Image by BruceBlaus
Coronary CT angiography of coronary arteries
Researchers have found that anti-inflammatory biologic therapies used to treat moderate to severe psoriasis can significantly reduce coronary inflammation in patients with the chronic skin condition. Scientists said the findings are particularly notable because of the use of a novel imaging biomarker, the perivascular fat attenuation index (FAI), that was able to measure the effect of the therapy in reducing the inflammation.
The study published online in JAMA Cardiology, has implications not just for people with psoriasis, but for those with other chronic inflammatory diseases, such as lupus and rheumatoid arthritis. These conditions are known to increase the risk for heart attacks and strokes. The study was funded by the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health.
In this image: Coronary CT angiography image of the coronary arteries depicting the perivascular fat attenuation index before and after biologic therapy at one-year follow-up for patients with excellent response to biologic therapy.
Image by Oxford Academic Cardiovascular CT Core Lab and Lab of Inflammation and Cardiometabolic Diseases at NHLBI
Coronary angiography (C) confirms the diagnosis, highlighting severe stenosis of the right coronary artery in the proximal and distal area, as well as in the common trunk.
Images obtained from a 73-year-old patient with chest pain. No perfusion abnormalities are observed on cardiac SPECT with 99m Tc-Tetrafosmin (A1 stress, A2 rest, A3 bullseye). PET with H 2 15 O (B1 stress, B2 rest, B3 bullseye), on the other hand, shows extensive deficits at the level of almost all the myocardium which partially disappear upon acquisition in resting conditions, to be referred to a balanced ischemia. Coronary angiography (C) confirms the diagnosis, highlighting severe stenosis of the right coronary artery in the proximal and distal area, as well as in the common trunk.
Image by Driessen et Al.
Coronary angiography
Angiogram, Blocked Artery : Angiogram showing blockage in a coronary artery.
Image by TheVisualMD
What is a Coronary Angiography and Angioplasty?
Video by SingHealth/YouTube
Coronary Angiography and Stent Interventions | Ravi Dave, MD | UCLAMDChat
Video by UCLA Health/YouTube
Coronary angiography - image intensifier basics and nomenclature
Video by Medmastery/YouTube
Coronary angiography
BruceBlaus
Coronary CT angiography of coronary arteries
Oxford Academic Cardiovascular CT Core Lab and Lab of Inflammation and Cardiometabolic Diseases at NHLBI
Coronary angiography (C) confirms the diagnosis, highlighting severe stenosis of the right coronary artery in the proximal and distal area, as well as in the common trunk.
Driessen et Al.
Coronary angiography
TheVisualMD
3:33
What is a Coronary Angiography and Angioplasty?
SingHealth/YouTube
23:51
Coronary Angiography and Stent Interventions | Ravi Dave, MD | UCLAMDChat
UCLA Health/YouTube
5:02
Coronary angiography - image intensifier basics and nomenclature
Medmastery/YouTube
Neurological Exam
Neurological Exam
Also called: Neurological Assessment, Neurological Examination, Neuro Exam
A neurological exam is a series of tests that check for disorders of the brain and spinal cord. These disorders cause serious health problems. The exam can help lead to diagnosis and treatment.
Neurological Exam
Also called: Neurological Assessment, Neurological Examination, Neuro Exam
A neurological exam is a series of tests that check for disorders of the brain and spinal cord. These disorders cause serious health problems. The exam can help lead to diagnosis and treatment.
A neurological exam is a group of questions and tests to check for disorders of your nervous system. It's sometimes called a "neuro" exam.
Your nervous system includes your:
Brain and spinal cord, which are also called your central nervous system
Peripheral nerves that carry signals back and forth between your central nervous system and all parts of your body, including your skin, muscles, and organs
Your nervous system plays a role in almost every part of your health and well-being. Because it controls so many body processes, a neurological exam has many different types of tests. The tests you have will depend on why you're having the exam. There are nerve tests to check for problems with your:
Muscle movement, balance, and coordination. These activities are controlled by nerves called motor nerves.
Breathing, heartbeat, digestion, and other processes that happen without thinking. Autonomic nerves control these activities.
Sense of touch, smell, hearing, and vision. Sensory nerves carry this information from your senses to your brain.
Thinking and memory. Certain parts of your brain control these and other types of complex mental activity, including your emotions.
A neurological exam may be used to:
Check the health of your nervous system during a routine checkup.
Help find out whether a nervous system disorder is causing certain symptoms. There are hundreds of disorders that affect the brain and nerves. Some examples include:
Degenerative nerve diseases, such as certain types of dementia and Parkinson's disease
Diabetic nerve problems
Epilepsy
Headache disorders, such as migraines and cluster headaches
Meningitis
Multiple sclerosis
Help find out if an injury has damaged part of the nervous system and how serious the damage may be.
Monitor a known nerve condition and/or see if treatment is helping.
You may need a neurological exam if you have symptoms that may be from a nervous system disorder. Because your nerves affect every part of your body, nervous system disorders can cause many different types of symptoms, including:
Pain in your back, neck, head, or along a nerve, such as sciatica
Tremors
Weak or stiff muscles
Problems with balance and/or coordination
Numb or tingling skin
Changes in any of your senses (hearing, vision, taste, smell, and touch)
Slurred speech
Confusion or other changes in mental ability
Seizures
You may also need a neurological exam if you have had an injury that may have damaged your peripheral nerves, spinal cord, or caused a traumatic brain injury (TBI).
A neurological exam is often done by a neurologist. A neurologist is a doctor who specializes in diagnosing and treating disorders of the nervous system. Certain other providers may also do a neurological exam.
The exam is usually done in a provider's office. If you've had a serious injury, the exam may be done in the emergency room or in the hospital.
First, the provider will usually:
Ask questions about any symptoms you may have
Ask about your medical history
Do a physical exam, including checking your heart and lungs
Next, the provider will do specific tests to check how different parts of your nervous system are working. The tests you have will depend on your symptoms. The tests may check your:
Mental status. This includes your memory, problem-solving ability, alertness, and mood. During a mental status exam, you may answer questions about the date, time, and where you are. You may also be asked to remember a list of items, name objects, repeat words, and/or draw specific shapes.
Cranial nerves. These 12 nerves connect your brain with your eyes, ears, nose, face, tongue, throat, shoulders, and certain organs. The provider will test the nerves that may be involved with your symptoms. For example, to test your sense of smell, you may be asked to sniff certain smells and identify what they are. If you're having speech problems, you may be asked to try to talk while you stick out your tongue.
Coordination, balance, and walking. These tests check how well your nervous system controls your muscle movements. You may be asked to walk in a straight line, placing one foot directly in front of the other. Other tests include checking your handwriting and having you touch your finger to your nose with your eyes closed.
Reflexes. A reflex is your body's automatic movement in response to certain triggers. For example, if your knee is tapped with a rubber hammer, your lower leg will jerk on its own. There are many types of reflexes that are tested in different ways. Reflex tests show how well nerves between your spinal cord and muscles are working.
Sensory nerves. The provider may test how well you can feel touch, hot and cold temperatures, vibrations, and pain. These tests involve gently touching part of your skin with different objects, such as a dull needle or a cotton swab. You will be asked to describe what you can feel.
Autonomic nervous system. A neurological exam tests the part of your nervous system that controls your breathing, heart rate, digestion, and other processes that happen without thinking. Examples of these tests include checking your blood pressure and heartbeat. Another test checks how your eyes respond to light.
You don't need any special preparations for a neurological exam.
There is no risk to having a neurological exam.
If the results of any part of your neurological exam are not normal, your provider will probably order more tests to help make a diagnosis. The tests will depend on what type of condition your provider thinks you could have. They may include:
Blood and/or urine tests
Imaging tests, such as an MRI
Cerebrospinal fluid (CSF) testing, also called a lumbar puncture
Biopsy
Electroencephalography (EEG) or electromyography (EMG), which use small electric sensors to measure brain activity and nerve function
If you have questions about your results, talk with your neurologist or other provider.
Nervous system disorders and mental health problems can have similar symptoms. For example, problems paying attention could be a symptom of either type of disorder. So in certain cases, your provider may do a mental health screening before or after a neurological exam.
Brain Biopsy
Brain Biopsy
Also called: Biopsy - Brain
A brain biopsy is typically performed after an imaging test confirmed the presence of a brain tumor or mass. The test is used to confirm or rule out brain cancer.
Brain Biopsy
Also called: Biopsy - Brain
A brain biopsy is typically performed after an imaging test confirmed the presence of a brain tumor or mass. The test is used to confirm or rule out brain cancer.
If imaging tests show there may be a brain tumor, a biopsy is usually done. One of the following types of biopsies may be used:
Stereotactic biopsy: When imaging tests show there may be a tumor deep in the brain in a hard to reach place, a stereotactic brain biopsy may be done. This kind of biopsy uses a computer and a 3-dimensional (3-D) scanning device to find the tumor and guide the needle used to remove the tissue. A small incision is made in the scalp and a small hole is drilled through the skull. A biopsy needle is inserted through the hole to remove cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer.
Open biopsy: When imaging tests show that there may be a tumor that can be removed by surgery, an open biopsy may be done. A part of the skull is removed in an operation called a craniotomy. A sample of brain tissue is removed and viewed under a microscope by a pathologist. If cancer cells are found, some or all of the tumor may be removed during the same surgery. Tests are done before surgery to find the areas around the tumor that are important for normal brain function. There are also ways to test brain function during surgery. The doctor will use the results of these tests to remove as much of the tumor as possible with the least damage to normal tissue in the brain.
The pathologist checks the biopsy sample to find out the type and grade of brain tumor. The grade of the tumor is based on how the tumor cells look under a microscope and how quickly the tumor is likely to grow and spread.
The following tests may be done on the tumor tissue that is removed:
Immunohistochemistry: A laboratory test that uses antibodies to check for certain antigens (markers) in a sample of a patient’s tissue. The antibodies are usually linked to an enzyme or a fluorescent dye. After the antibodies bind to a specific antigen in the tissue sample, the enzyme or dye is activated, and the antigen can then be seen under a microscope. This type of test is used to help diagnose cancer and to help tell one type of cancer from another type of cancer.
Light and electron microscopy: A laboratory test in which cells in a sample of tissue are viewed under regular and high-powered microscopes to look for certain changes in the cells.
Cytogenetic analysis: A laboratory test in which the chromosomes of cells in a sample of brain tissue are counted and checked for any changes, such as broken, missing, rearranged, or extra chromosomes. Changes in certain chromosomes may be a sign of cancer. Cytogenetic analysis is used to help diagnose cancer, plan treatment, or find out how well treatment is working.
For some tumors, a biopsy or surgery cannot be done safely because of where the tumor formed in the brain or spinal cord. These tumors are diagnosed and treated based on the results of imaging tests and other procedures.
Sometimes the results of imaging tests and other procedures show that the tumor is very likely to be benign and a biopsy is not done.
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https://www.mercy.com/health-care-services/cancer-care-oncology/specialties/brain-tumor-treatment/treatments/brain-biopsy [accessed on Sep 19, 2019]
Additional Materials (7)
Brain biopsy under stereotaxy.
Brain biopsy under stereotaxy. A small part of the tumor is taken via a needle with a vacuum system. The frame around the patient's head ensures a correct axis towards the target (max. error : ~1 mm)
Image by Dake~commonswiki
What to know about a brain tumor diagnosis
Video by Mayo Clinic/YouTube
How Liquid Biopsies Can Improve Brain Tumor Diagnoses
Video by MassGeneralHospital/YouTube
Stereotactic brain biopsy
Video by Institute for Cancer Genetics and Informatics/YouTube
Brain Tumor Diagnosis and Treatment - Mayo Clinic
Video by Mayo Clinic/YouTube
Brain Tumour facts: 10 things you should know about brain tumours | Cancer Research UK
Video by Cancer Research UK/YouTube
Distinguishing Brain Tumors
Video by Lee Health/YouTube
Brain biopsy under stereotaxy.
Dake~commonswiki
1:43
What to know about a brain tumor diagnosis
Mayo Clinic/YouTube
3:24
How Liquid Biopsies Can Improve Brain Tumor Diagnoses
MassGeneralHospital/YouTube
2:20
Stereotactic brain biopsy
Institute for Cancer Genetics and Informatics/YouTube
7:02
Brain Tumor Diagnosis and Treatment - Mayo Clinic
Mayo Clinic/YouTube
1:08
Brain Tumour facts: 10 things you should know about brain tumours | Cancer Research UK
Cancer Research UK/YouTube
1:49
Distinguishing Brain Tumors
Lee Health/YouTube
Cerebrospinal Fluid Analysis
Cerebrospinal Fluid Analysis
Also called: CSF Analysis, Spinal Fluid Analysis
A cerebrospinal fluid (CSF) analysis is a group of tests that help diagnose diseases and conditions affecting the brain and spinal cord.
Cerebrospinal Fluid Analysis
Also called: CSF Analysis, Spinal Fluid Analysis
A cerebrospinal fluid (CSF) analysis is a group of tests that help diagnose diseases and conditions affecting the brain and spinal cord.
Cerebrospinal fluid (CSF) is a clear, colorless liquid found in your brain and spinal cord. The brain and spinal cord make up your central nervous system. Your central nervous system controls and coordinates everything you do including, muscle movement, organ function, and even complex thinking and planning. CSF helps protect this system by acting like a cushion against sudden impact or injury to the brain or spinal cord. CSF also removes waste products from the brain and helps your central nervous system work properly.
A CSF analysis is a group of tests that look at your cerebrospinal fluid to help diagnose diseases and conditions that affect the brain and spinal cord.
A CSF analysis may include tests to diagnose:
Infectious diseases of the brain and spinal cord, including meningitis and encephalitis. CSF tests for infections look at white blood cells, bacteria, and other substances in the cerebrospinal fluid
Autoimmune disorders, such as Guillain-Barré Syndrome and multiple sclerosis (MS). CSF tests for these disorders look for high levels of certain proteins in the cerebrospinal fluid. These tests are called albumin protein and igG/albumin.
Bleeding in the brain
Brain tumors
You may need a CSF analysis if you have symptoms of an infection of the brain or spinal cord, or of an autoimmune disorder, such as multiple sclerosis (MS).
Symptoms of a brain or spinal cord infection include:
Fever
Severe headache
Seizures
Stiff neck
Nausea and vomiting
Sensitivity to light
Double vision
Changes in behavior
Confusion
Symptoms of MS include:
Blurred or double vision
Tingling in the arms, legs, or face
Muscle spasms
Weak muscles
Dizziness
Bladder control problems
Symptoms of Guillain-Barré syndrome include weakness and tingling in the legs, arms, and upper body.
You may also need a CSF analysis if you've had an injury to your brain or spinal cord, or have been diagnosed with cancer that has spread to the brain or spinal cord.
Your cerebrospinal fluid will be collected through a procedure called a spinal tap, also known as a lumbar puncture. A spinal tap is usually done in a hospital. During the procedure:
You will lie on your side or sit on an exam table.
A health care provider will clean your back and inject an anesthetic into your skin, so you won't feel pain during the procedure. Your provider may put a numbing cream on your back before this injection.
Once the area on your back is completely numb, your provider will insert a thin, hollow needle between two vertebrae in your lower spine. Vertebrae are the small backbones that make up your spine.
Your provider will withdraw a small amount of cerebrospinal fluid for testing. This will take about five minutes.
You'll need to stay very still while the fluid is being withdrawn.
Your provider may ask you to lie on your back for an hour or two after the procedure. This may prevent you from getting a headache afterward.
You don't need any special preparations for a CSF analysis, but you may be asked to empty your bladder and bowels before the test.
There is very little risk to having a spinal tap. You may feel a little pinch or pressure when the needle is inserted. After the test, you may get a headache, called a post-lumbar headache. About one in 10 people will get a post-lumbar headache. This can last for several hours or up to a week or more. If you have a headache that lasts longer than several hours, talk to your health care provider. He or she may be able to provide treatment to relieve the pain.
You may feel some pain or tenderness in your back at the site where the needle was inserted. You may also have some bleeding at the site.
Your CSF analysis results may indicate that you have an infection, an autoimmune disorder, such as multiple sclerosis, or another disease of the brain or spinal cord. Your provider will likely order more tests to confirm your diagnosis.
Some infections, such as meningitis caused by bacteria, are life-threatening emergencies. If your provider suspects you have bacterial meningitis or another serious infection, he or she may give you medicine before your diagnosis is confirmed.
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Cerebrospinal Fluid Analysis - - American Family Physician [accessed on Oct 01, 2018]
Cerebrospinal Fluid | Lab Tests | GLOWM [accessed on Oct 01, 2018]
CSF Analysis - Neurology - Michigan Medicine Confluence [accessed on Oct 01, 2018]
Additional Materials (17)
Ventricular system
The Human en:Ventricular system colored and animated
Image by en:Anatomography
Lumbar puncture
Image by BruceBlaus
What is hydrocephalus and what are the different types?
Illustration showing different effects of hydrocephalus on the brain and cranium.
Image by Centers for Disease Control and Prevention
Hydrocephalus - Who gets it and what causes it?
Image by Vimont, Engelmann /Scan by NLM
Cerebrospinal fluid and System
Cerebrospinal fluid and System
Image by Blausen.com staff (2014). "Medical gallery of Blausen Medical 2014"
Diagram showing how you have a lumbar puncture.
Diagram showing how you have a lumbar puncture.
Image by Cancer Research UK / Wikimedia Commons
Normal Pressure Hydrocephalus
Images from a patient with normal pressure hydrocephalus (NPH)
Image by Nevit Dilmen
Normal Pressure Hydrocephalus
Hydrocephalus _ Animated MRI Images from a patient with normal pressure hydrocephalus
Image by Nevit Dilmen
4 vials of human cerebrospinal fluid
4 vials of human cerebral spinal fluid of normal appearance, collected via lumbar puncture from the L3/L4 disk space.
Image by James Heilman, MD
Epidural blood patch
Illustration of Epidural blood patch
Image by Gurch
Lumbar puncture
Lumbar puncture procedure in a new born infant in a Neonatal Medium Care Unit, Maracay, Venezuela.
Image by Bobjgalindo
Spinal Cord Cross Section
Spinal Cord Cross Section
Image by OpenStax College
Lumbar Vertebrae
3D visualization based on scanned human data of lumbar vertebrae. Strong and wide lumbar vertebrae bear weight of the body and provide stability.
Image by TheVisualMD
Lumbar Puncture
Video by DrER.tv/YouTube
Lumbar Spine Anatomy
Video by Randale Sechrest/YouTube
Lumbar Puncture
Lumbar Puncture
Image by Blausen.com staff (2014). "Medical gallery of Blausen Medical 2014"
Healthy Brain cross section
Brain with Ischemic Stroke cross section
Brain with Hemorrhagic Stroke, cross section
1
2
3
Types of Stroke
Cross Section
1) Healthy Brain - This cross-sectional image through the frontal plane of the head of a healthy individual reveals the temporal and frontal lobes of the brain, along with some major structures visible at this level. The vertebral arteries enter the skull through the foramen magnum. They meet to form the basilar artery, then ultimately branch into the posterior cerebral arteries. The Circle of Willis is a pattern of arteries in the center of the brain, surrounding the pituitary gland. The ventricles are fluid-filled cavities in the brain continuous with the central canal of the spinal cord, housing cells that produce and secrete cerebrospinal fluid. This fluid lubricates and has an immunological function.
2) Ischemic Stroke - This cross-sectional image through the frontal plane of the head of a healthy individual reveals the temporal and frontal lobes of the brain, along with some major structures visible at this level. A portion of dead brain tissue can be seen on the individual's left side of the brain near the surface. The dead tissue is due to an ischemic stroke, most likely a result of blockage in an artery to the brain. The blockage can also occur elsewhere in the body, but break apart and travel through the bloodstream, getting caught in the smaller arteries in the brain. Blood is unable to reach the tissue destination, and therefore that tissue becomes necrotic. The cause of blockage in the first place is likely due to fatty deposits in arterial walls, or atherosclerosis.
3) Hemorrhagic Stroke - This cross-sectional image through the frontal plane of the head of a healthy individual reveals the temporal and frontal lobes of the brain, along with some major structures visible at this level. A hemorrhagic stroke has occurred, as indicated by the area of bleeding on the individual's left side of the brain. A hemorrhagic stroke can occur when a vessel weakened by conditions such as an aneurysm or arteriovenous malformation (AVM) ruptures, allowing blood to leak out into the surrounding tissues. These conditions can be congenital, but risks may increase due to high blood pressure, high cholesterol, smoking, and atherosclerosis.
Interactive by TheVisualMD
Ventricular system
en:Anatomography
Lumbar puncture
BruceBlaus
What is hydrocephalus and what are the different types?
Centers for Disease Control and Prevention
Hydrocephalus - Who gets it and what causes it?
Vimont, Engelmann /Scan by NLM
Cerebrospinal fluid and System
Blausen.com staff (2014). "Medical gallery of Blausen Medical 2014"
Diagram showing how you have a lumbar puncture.
Cancer Research UK / Wikimedia Commons
Normal Pressure Hydrocephalus
Nevit Dilmen
Normal Pressure Hydrocephalus
Nevit Dilmen
4 vials of human cerebrospinal fluid
James Heilman, MD
Epidural blood patch
Gurch
Lumbar puncture
Bobjgalindo
Spinal Cord Cross Section
OpenStax College
Lumbar Vertebrae
TheVisualMD
4:06
Lumbar Puncture
DrER.tv/YouTube
5:32
Lumbar Spine Anatomy
Randale Sechrest/YouTube
Lumbar Puncture
Blausen.com staff (2014). "Medical gallery of Blausen Medical 2014"
Types of Stroke
TheVisualMD
Staging
Cancer staging
Image by TheVisualMD
Cancer staging
Staging Cancer : Staging is the process of finding out the amount of cancer in the body and if it has spread. Most tumorous cancers are staged using the TNM system. In the TNM system, T = extent of the primary tumor, N = extent of spread to lymph nodes, M = presence of metastasis. After the TNM description has been decided, the cancer can be designated as Stage 0-IV. Stage 0 =carcinoma in situ. In Stage I, Stage II, and Stage III, higher numbers indicate more extensive disease, ie, greater tumor size, and/or spread of the cancer to nearby lymph nodes, and/or organs adjacent to the primary tumor. In Stage IV, the cancer has spread to another organ.
Image by TheVisualMD
Stages of Adult Central Nervous System Tumors
KEY POINTS
There is no standard staging system for adult brain and spinal cord tumors.
Imaging tests may be repeated after surgery to help plan more treatment.
CNS tumors often recur, sometimes many years after treatment.
There is no standard staging system for adult brain and spinal cord tumors.
The process used to find out if cancer has spread to other areas of the brain or to other parts of the body is called staging. Brain tumors that begin in the brain rarely spread to other parts of the body. There is no standard staging system for brain and spinal cord tumors.
Treatment of primary brain and spinal cord tumors is based on the following:
The type of cell in which the tumor began.
Where the tumor formed in the brain or spinal cord.
The amount of cancer left after surgery.
The grade of the tumor.
Treatment of tumors that have spread to the brain from other parts of the body is based on the number of tumors in the brain.
Imaging tests may be repeated after surgery to help plan more treatment.
Some of the tests and procedures used to diagnose a brain or spinal cord tumor may be repeated after treatment to find out how much tumor is left.
CNS tumors often recur, sometimes many years after treatment.
A recurrent central nervous system (CNS) tumor is a tumor that has recurred (come back) after it has been treated. The tumor may recur at the same place as the first tumor or in other parts of the central nervous system.
Source: National Cancer Institute (NIH)
Additional Materials (4)
Staging Cancer
Cancer staging, that is, determining the extent and spread of cancer in the body, is used by doctors to plan treatment and to arrive at a prognosis (estimate of future course and outcome) for the disease.
Image by TheVisualMD
Brainstem Glioma in 4 year old
Brainstem Glioma in 4 year old. MRI sagittal, without contrast.
Image by Tdvorak
Glioma Brain Tumor | Dave’s Story
Video by Johns Hopkins Medicine/YouTube
Expectations After Brain Tumor Treatment
Video by Johns Hopkins Medicine/YouTube
Staging Cancer
TheVisualMD
Brainstem Glioma in 4 year old
Tdvorak
3:31
Glioma Brain Tumor | Dave’s Story
Johns Hopkins Medicine/YouTube
2:28
Expectations After Brain Tumor Treatment
Johns Hopkins Medicine/YouTube
Treatment
Radiation therapy
Image by Taheri-Kadkhoda et al. Radiation Oncology
Radiation therapy
Irradiation of nasopharyngeal carcinoma by photon (X-ray) therapy (left) and proton therapy (right)
Image by Taheri-Kadkhoda et al. Radiation Oncology
Adult Central Nervous System Tumors Treatment Options
Treatment Option Overview
KEY POINTS
There are different types of treatment for patients with adult brain and spinal cord tumors.
Five types of standard treatment are used:
Active surveillance
Surgery
Radiation therapy
Chemotherapy
Targeted therapy
Supportive care is given to lessen the problems caused by the disease or its treatment.
New types of treatment are being tested in clinical trials.
Proton beam radiation therapy
Immunotherapy
Treatment for adult central nervous system tumors may cause side effects.
Patients may want to think about taking part in a clinical trial.
Patients can enter clinical trials before, during, or after starting their cancer treatment.
Follow-up tests may be needed.
There are different types of treatment for patients with adult brain and spinal cord tumors.
Different types of treatment are available for patients with adult brain and spinal cord tumors. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
Five types of standard treatment are used:
Active surveillance
Active surveillance is closely watching a patient’s condition but not giving any treatment unless there are changes in test results that show the condition is getting worse. Active surveillance may be used to avoid or delay the need for treatments such as radiation therapy or surgery, which can cause side effects or other problems. During active , certain exams and tests are done on a regular schedule. Active may be used for very slow-growing tumors that do not cause symptoms.
Surgery
Surgery may be used to diagnose and treat adult brain and spinal cord tumors. Removing tumor tissue helps decrease pressure of the tumor on nearby parts of the brain.
After the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given chemotherapy or radiation therapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to lower the risk that the cancer will come back, is called adjuvant therapy.
Radiation therapy
Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. External radiation therapy uses a machine outside the body to send radiation toward the area of the body with cancer.
Certain ways of giving external radiation therapy can help keep radiation from damaging nearby healthy tissue. These types of radiation therapy include the following:
Conformal radiation therapy: Conformal radiation therapy uses a computer to make a 3-dimensional (3-D) picture of the tumor and shapes the radiation beams to fit the tumor.
Intensity-modulated radiation therapy (IMRT): IMRT is a type of 3-dimensional (3-D) radiation therapy that uses a computer to make pictures of the size and shape of the tumor. Thin beams of radiation of different intensities (strengths) are aimed at the tumor from many angles.
Stereotactic radiosurgery: Stereotactic radiosurgery uses a rigid head frame that is attached to the skull to keep the head still during the radiation treatment. A machine aims a single large dose of radiation directly at the tumor. This procedure does not involve surgery. It is also called stereotaxic radiosurgery, radiosurgery, and radiation surgery.
Chemotherapy
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). Although most cannot, some chemotherapy drugs can cross the blood-brain barrier and reach tumor cells in the brain. Chemotherapy that is placed directly into the cerebrospinal fluid is called intrathecal chemotherapy. When chemotherapy is inserted in an organ, such as the brain, or a body cavity, the drugs mainly affect cancer cells in those areas (regional chemotherapy).
To treat brain tumors, a wafer that dissolves may be used to deliver a chemotherapy drug directly to the brain tumor site after the tumor has been removed by surgery. The way the chemotherapy is given depends on the type and grade of tumor and where it is in the brain.
Targeted therapy
Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells. Targeted therapies usually cause less harm to normal cells than chemotherapy or radiation therapy do.
Monoclonal antibody therapy: Monoclonal antibodies are immune system proteins made in the laboratory to treat many diseases, including cancer. As a cancer treatment, these antibodies can attach to a specific target on cancer cells or other cells that may help cancer cells grow. The antibodies are able to then kill the cancer cells, block their growth, or keep them from spreading. Monoclonal antibodies are given by infusion. They may be used alone or to carry drugs, toxins, or radioactive material directly to cancer cells.
Bevacizumab is a monoclonal antibody that binds to a protein called vascular endothelial growth factor (VEGF) and may prevent the growth of new blood vessels that tumors need to grow. Bevacizumab is used in the treatment of recurrent glioblastoma.
Source: National Cancer Institute (NIH)
Additional Materials (9)
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Radiation therapy
Woman Prepared for Radation Therapy Description A female patient is lying on a bed with a technician positioning the patient's head in preparation for radiotherapy. This photograph was used in the NCI publication "When Someone in Your Family Has Cancer".
Image by Michael Anderson (Photographer) / National Cancer Institute
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Proton Beam During CT Scans
A proton beam from the brain during CT scans. Top view of proton beams entering head. Bright pink area is tumor. Beams are focused only in this area reducing harm to surrounding tissue.
Image by National Cancer Institute / Unknown Photographer
Proton Beam Therapy
A computer generated image displays focused, positively charged atomic particles. Proton beam therapy uses protons to destroy cancer cells, rather than electrons which are used in traditional radiation therapy.
Image by Dr. Michael Goitein. Massachusettes General Hospital / Unknown Photographer
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Proton therapy
Proton Beam Therapy : A proton beam from the brain during CT scans. Using dozens of CT slices, a computer produced this three-dimensional representation of the eyes and optic nerves (blue and green). The brain stem (green) , and the tumor (red). The yellow line shows the proton beam field-shaping aperture.
Image by NCI / National Cancer Institute
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Doctors Review Brain Images
A female and a male doctor review a close-up image of a patient's brain in dosimetry planning for treating brain tumors.
Image by National Cancer Institute / Rhoda Baer (Photographer)
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Targeted Nanochains in Brain Tumor
Nanoparticle penetration of brain tumors can be limited due to protective barriers around the brain and the tumor. Access to invasive tumors that have spread throughout the brain is even more challenging. Nanoparticles with a linear chain-like design, called nanochains, may more effectively penetrate invasive brain tumors. Here, mice with invasive glioma tumors were injected with nanochains decorated with tumor-targeting molecules. These MRI images show that the nanochains (blue) are able to penetrate the original glioma brain tumor as well as invasive cancer cells that have spread into the surrounding areas.
This image is part of the following collections:
NCI Cancer Close Up 2017
Nanotechnology Image Library
Image by National Cancer Institute \ Case Western Reserve University / Gil Covarrubias, David Wilson, Chris Flask, Efstathios Karathanasis
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Doctor Review Brain Images
A Caucasian male doctor reviews brain images in the dosimetry planning of radiation therapy for brain tumors.
Image by National Cancer Institute / Rhoda Baer (Photographer)
New Therapies for Brain Tumors
Video by MassGeneralHospital/YouTube
Radiation treatment
Capt. Candice Adams Ismirle waits to receive a radiation treatment Oct. 22, 2013, at Walter Reed National Military Medical Center in Bethesda, Md. After approximately two years in remission, Ismirle recently learned her cancer had returned.
Image by U.S. Air Force photo/Staff Sgt. Russ Scalf
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Radiation therapy
Michael Anderson (Photographer) / National Cancer Institute
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Proton Beam During CT Scans
National Cancer Institute / Unknown Photographer
Proton Beam Therapy
Dr. Michael Goitein. Massachusettes General Hospital / Unknown Photographer
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Proton therapy
NCI / National Cancer Institute
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Doctors Review Brain Images
National Cancer Institute / Rhoda Baer (Photographer)
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Targeted Nanochains in Brain Tumor
National Cancer Institute \ Case Western Reserve University / Gil Covarrubias, David Wilson, Chris Flask, Efstathios Karathanasis
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Doctor Review Brain Images
National Cancer Institute / Rhoda Baer (Photographer)
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Brain Tumors
A brain tumor is a growth of abnormal cells in the brain tissue that can be benign or malignant. Some are primary brain tumors, which start in the brain. Others are metastatic, and they start somewhere else in the body and move to the brain. Learn about the different types of brain tumors, common symptoms, and treatment options.