Symptoms of both primary and secondary brain tumors can be divided into three main

categories:

Symptoms as consequences of increased intracranial pressure (often first noticed): Large

tumors or tumors with extensive peritumoral swelling (edema) inevitably lead to elevated
intracranial pressure which translates clinically into headaches, vomiting (with or without
nausea), altered state of consciousness (somnolence, coma), dilation of the pupil on the
side of the lesion (anisocoria), papilledema (prominent optic disc at the funduscopic eye
examination). However, even small tumors obstructing the passage of cerebrospinal fluid
(CSF) can also present such symptoms. Increased intracranial pressure may result in brain
herniation (i.e. displacement) of certain parts of the brain, such as the cerebellar tonsils or
the temporal uncus, resulting in lethal brainstem compression. In very young children,
elevated intracranial pressure may cause an increase in the diameter of the skull and
bulging of the fontanelles.
Dysfunction: depending on the tumor location and the damage it may have caused to
surrounding brain structures, either through compression or infiltration, any type of focal
neurologic symptoms may occur, such as cognitive and behavioral impairment (including
impaired judgment, memory loss, lack of recognition, spatial orientation disorders),
personality or emotional changes, hemiparesis, hypoesthesia, aphasia, ataxia, visual field
impairment, impaired sense of smell, impaired hearing, facial paralysis, double vision,
dizziness, but more severe symptoms might occur too, such as paralysis on one side of the
body hemiplegia or impairment in swallowing. These symptoms are not specific for brain
tumors they may be caused by a large variety of neurologic conditions (e.g. stroke,
traumatic brain injury). What counts, however, is the location of the lesion and the
functional systems (e.g. motor, sensory, visual, etc.) it affects. A bilateral temporal visual
field defect (bitemporal hemianopiadue to compression of the optic chiasm), often
associated with endocrine dysfunctioneither hypopituitarism or hyperproduction of
pituitary hormones and hyperprolactinemia is suggestive of a pituitary tumor.
Irritation: abnormal fatigue, weariness, absences and tremors, but also epileptic seizures.
A benign brain tumor may be present for some years and be asymptomatic. Others might
present ambiguous and intermittent symptoms like headaches and vomiting or weariness
and so be mistaken for gastrointestinal disorders. In these cases secondary symptoms need
to be looked into.