Common Localizing Manifestations of Primary Brain Tumors
Tumor Site | Findings | Common Primary Tumor Types* |
|---|---|---|
Anterior corpus callosum | Cognitive impairment | Astrocytoma (including low-grade gliomas) |
Basal ganglia | Hemiparesis (contralateral), movement disorders | Astrocytoma (including low-grade gliomas) Primary CNS lymphoma |
Brain stem | Unilateral or bilateral motor or sensory loss, cranial nerve deficits (eg, gaze palsies, hearing loss, vertigo, palatal paresis, facial weakness), ataxia, intention tremor, nystagmus | Astrocytoma (including juvenile pilocytic astrocytoma) Diffuse pontine glioma |
Cerebellopontine angle | Tinnitus and hearing loss (both ipsilateral), vertigo, loss of vestibular response to caloric stimulation If tumor is large, ataxia, loss of facial sensation and facial weakness (both ipsilateral), possibly other cranial nerve or brain stem deficits | |
Cerebellum | Ataxia, nystagmus, tremor, hydrocephalus with suddenly increased intracranial pressure | Astrocytoma (including juvenile pilocytic astrocytoma) |
2nd cranial (optic) nerve | Loss of vision | Astrocytoma (including pilocytic astrocytomas and lower-grade gliomas; optic nerve location most common in neurofibromatosis) |
5th cranial (trigeminal) nerve | Facial pain, loss of sensation, jaw weakness | Meningioma Schwannoma |
Frontal lobe | Generalized or focal (contralateral) seizures, gait disorders, urinary urgency or incontinence, impaired attention and cognition and apathy (particularly if tumor is bilateral), hemiparesis Expressive aphasia if tumor is in dominant hemisphere Anosmia if tumor is at base of lobe | Astrocytoma Glioblastoma Oligodendroglioma |
Hypothalamus | Eating and drinking disorders (eg, polydipsia), precocious puberty (especially in boys), hypothermia | Astrocytoma |
Occipital lobe | Generalized seizures with visual aura, visual hallucinations, hemianopia or quadrantanopia (contralateral) | Astrocytoma Glioblastoma Oligodendroglioma |
Parietal lobe | Deficits in position sensation and in 2-point discrimination (contralateral), anosognosia (no recognition of bodily defects), denial of illness, hemianopia (contralateral), generalized or focal seizures, inability to perceive (extinguishing of) a contralateral stimulus when stimuli are applied to both sides of the body (called double simultaneous stimulation) Receptive aphasia if tumor is in dominant hemisphere | Astrocytoma Glioblastoma Oligodendroglioma |
Paresis of upward gaze, ptosis, loss of pupillary light and accommodation reflexes, sometimes hydrocephalus with suddenly increased intracranial pressure | Germ cell tumor Pineocytoma (rare) | |
Pituitary or suprasellar region | Endocrinopathies, monocular visual loss, headache without increased intracranial pressure, bitemporal hemianopia | Craniopharyngioma Pituitary carcinoma (rare) |
Temporal lobe | Complex partial seizures, generalized seizures with or without aura, hemianopia (contralateral), mixed expressive and receptive aphasia or anomia | Astrocytoma Glioblastoma Oligodendroglioma |
Thalamus | Sensory impairment (contralateral) | Astrocytoma |
* Similar manifestations may result from brain parenchymal metastases or from tumors around the dura (eg, metastatic tumors; meningeal tumors such as meningiomas, sarcomas, or gliomas) or skull lesions (eg, granulomas, hemangiomas, osteitis deformans, osteomas, xanthomas) that compress the underlying brain. | ||
CNS = central nervous system. | ||