Gliomas: Symptoms, Complaints, Signs

The following symptoms and complaints may indicate gliomas:

• Change in behavior, nature
• Aphasia (“speechlessness”)
• Apraxia – inability to perform purposeful actions.
• Respiratory disorders
• Disturbances of consciousness/alterations of consciousness
• Cephalgia (headache) – new onset; unusual; especially at night and early morning; often improves spontaneously during the day; present as the first and only symptom in only 2-8% of all patients; localization:
  • Tension headache (majority of patients).
  • Frontal pain (considered nonspecific).
  • Occipital pain (common with infratentorial processes).
  • Headache does not correlate with the size of the tumor
• Dysosmia (olfactory disorders).
• Epilepsy (seizure) [most common primary symptom of glioma; furthermore, brain metastases often manifest initially as seizures].
• Gait disorders / coordination disorders
• Intellectual degradation
• Concentration disorders
• Circulatory disorders
• Fatigue / listlessness
• Nausea (nausea)/vomiting
• Paresis (paralysis)
• Visual disturbances, diplopia (double vision, double images).
• Sensory disturbances
• Speech disorders
• Vertigo (dizziness)

Local symptoms include paresis (paralysis), sensory, visual, or speech disturbances.General signs of intracranial pressure include headache, vomiting, papilledema (swelling (edema) at the junction of the optic nerve with the retina, which manifests as protrusion of the optic disc; congestive papilledema usually bilateral), or changes in consciousness.

Acute intracranial pressure signs are:

• Severe (esp.) nocturnal or morning headache
• (morning) nausea (nausea)/fasting vomiting.
• Meningismus (neck stiffness)
• Increasing vigilance reduction (reduction in vigilance).

Chronic intracranial pressure signs include:

• Chronic headache
• Difficulty concentrating/changes of mind
• Fatigue

Brain tumors in children and adolescents

The following symptoms and complaints may indicate brain tumors in children and adolescents:

• Lethargy
• Drowsiness
• Failure to thrive
• Visual disturbances (newborns to four years of age).
• Cephalgia* (headache) (older children and young adults aged 5 to 24 years).
• Cerebral pressure signs (such as nausea (nausea)/vomiting* , papilledema (swelling (edema) at the junction of the optic nerve with the retina, which manifests as protrusion of the optic disc; congestive papilledema usually bilateral), seizures).
• Focal neurologic symptoms (selective neurologic deficits caused by smaller, circumscribed lesions of the central nervous system; less common than the localizable symptoms listed above)

* Headache and vomiting: 50-60% of casesNote: Nearly all children with cephalgia (headache) due to brain tumor present with additional neurologic abnormalities.

Localization-related leading symptoms in CNS tumors.