Neurology

Brain tumours

Brain tumours are primary or metastatic intracranial neoplasms that can present through seizures, progressive focal dysfunction or raised intracranial pressure; diagnosis and treatment depend on imaging, tissue, molecular profile, site and performance status.

Definition

A brain tumour is an abnormal intracranial neoplasm, either primary or metastatic. It causes symptoms through mass effect, infiltration, oedema, obstruction of cerebrospinal-fluid flow, raised intracranial pressure and cortical irritation.

First principles

A tumour grows inside a fixed skull

A growing tumour and its surrounding vasogenic oedema compete with brain, blood and cerebrospinal-fluid volume. Compensation can fail quickly, causing raised intracranial pressure, hydrocephalus, shift and herniation. A histologically benign lesion can therefore be dangerous if it obstructs cerebrospinal-fluid flow or compresses critical structures.

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