How is it assessed?
When the brain is affected by a tumour it functions abnormally and causes symptoms as described. Signs of damage can often be found on neurological examination. This is a detailed examination of nerve function in the body and can sometimes give a picture of likely pathology. Investigations used will depend on the cause of the problem and can include either alone or in combination:
- Computed Tomography (CT) scan.
- Magnetic Resonance Imaging (MRI) scan.
- Blood tests – include tests to measure hormone function if a pituitary tumour is suspected and tumour markers to test for germ cell tumours.
- Lumbar puncture - assesses Cytology (appearance of cells).
- Electroencephalography (EEG) - recording of electrical activity from the scalp to investigate seizure disorders (fits).
- Ophthalmology tests - acuity, colour, visual fields.
- Audiology tests - assess hearing.
Biopsy – this will be performed under general anaesthetic and may be ‘open’ under direct vision by the neurosurgeon usually as part of therapeutic resection (removal of tumour) or ‘stereotactically’ by using a needle directed under MRI or CT guidance. For midline tumours the surgeon may use a Neuroendoscope – a thin flexible tube with a camera which can navigate through and examine the cerebrospinal fluid (CSF) spaces in and around the brain.
