Last reviewed: June 2019
Last updated: January  2017



History and exam

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
  • papilledema
  • 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 gender
  • neurofibromatosis type 1
  • tuberous sclerosis
  • Li-Fraumeni syndrome
  • Turcot syndrome
  • ionizing radiation

Diagnostic investigations

1st investigations to order

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

Investigations to consider

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

Treatment algorithm


Authors VIEW ALL

Associate Professor of Medicine

Cleveland Clinic




MSA has acted as a consultant for Elekta, Incyte, AstraZeneca, Novocure, Caris Life Sciences, Bristol-Myers Squibb, Monteris Medical, AbbVie, MRI Solutions, Elsevier, and Prime oncology. MSA has received clinical trial investigations grants from Tracon, Bristol-Myers Squibb, AstraZeneca, Novartis, and Novocure.

Professor of Neurosurgery

University of California

San Francisco



SC has received research support from Agios, Novartis, Quest, Roche, and Schering Plough.

Dr Manmeet S. Ahluwalia and Dr Susan Chang would like to gratefully acknowledge Dr Karine Michaud, the previous contributor to this monograph. KM declares that she has no competing interests.

Peer reviewers VIEW ALL

Associate Professor

The Preston Robert Tisch Brain Tumor Center

Duke University Medical Center




DAR declares that he has no competing interests.

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