Last reviewed:September 2019
Last updated:October  2019

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors

Other diagnostic factors

  • altered mental status
  • headache
  • nausea and/or vomiting
  • gait abnormality
  • ataxia
  • weakness
  • seizures
  • visual disturbances
  • speech deficit
  • aphasia/dysphasia
  • sensory deficit
  • motor weakness
  • visual change
  • cranial nerve palsy
  • papilloedema
  • personality change/emotional lability
  • cognitive decline
  • nystagmus
  • ipsilateral dysmetria
  • acalculia
  • finger agnosia
  • left-right confusion
  • alexia (without agraphia)
  • neglect
  • hypothalamic syndrome

Risk factors

  • white ancestry
  • male sex
  • neurofibromatosis type 1
  • tuberous sclerosis
  • Li-Fraumeni syndrome
  • Turcot's cancer syndrome
  • ionising radiation

Diagnostic investigations

1st investigations to order

  • MRI head
  • ophthalmological evaluation; visual field testing
  • CT head
  • spectroscopy MRI head
  • perfusion MRI head
  • biopsy
Full details

Investigations to consider

  • pituitary hormones tests
  • diffusion tensor imaging (DTI)
Full details

Emerging tests

  • 2-hydroxyglutarate-targeted magnetic resonance spectroscopy
Full details

Treatment algorithm

Contributors

Chief of Neurosurgery

Dartmouth-Hitchcock Medical Center

Lebanon

NH

Disclosures

TCR is an author of a number of references cited in this topic.

Assistant Professor of Neurosurgery

Dartmouth-Hitchcock Medical Center

Lebanon

NH

Disclosures

LTE declares that he has no competing interests.

Dr Timothy C. Ryken and Dr Linton T. Evans would like to gratefully acknowledge Dr Manmeet S. Ahluwalia, Dr Susan Chang, and Dr Karine Michaud, previous contributors to this topic.

Peer reviewersVIEW ALL

Associate Professor

The Preston Robert Tisch Brain Tumor Center

Duke University Medical Center

Durham

NC

Disclosures

DAR declares that he has no competing interests.

Use of this content is subject to our disclaimer