Table of ContentsView AllTable of ContentsSelf-ChecksPhysical ExamImagingLabs and TestsDifferential DiagnosesFrequently Asked QuestionsNext in Brain Tumor GuideWhat Is a Brain Tumor?
Table of ContentsView All
View All
Table of Contents
Self-Checks
Physical Exam
Imaging
Labs and Tests
Differential Diagnoses
Frequently Asked Questions
Next in Brain Tumor Guide
Abrain tumorcan be diagnosed using imaging tests that view the structure of the brain, along with a biopsy, which can carefully assess a sample of a suspectedbrain tumorunder a microscope. Generally, before these tests are ordered, a physical examination is done to determine whether there are neurological changes that suggest the presence of a brain tumor. In the end, diagnosis of a brain tumor can involve an MRI, CT scan, blood tests, lumbar puncture, and biopsy.
A brain tumor is located inside the skull, so there are generally no changes that you are able to see on your own. However, there are a fewsigns of brain tumorsthat you should be aware of, especially because they can be subtle and slowly progressive.
Be sure to take note of any of the following and bring them to the attention of your healthcare provider:
*While persistent headaches can be a sign of a brain tumor, they—in the absence of other symptoms—are rarely owed to one. Still, see your healthcare provider.
Physical Examination
Your healthcare provider’s physical examination can help determine whether you have a possible brain tumor.
Signs of a brain tumor on a physical examination can include weakness as well as a tremor, coordination problems on both sides of your body, or jerking movements of your eyes.
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Imaging can assess the size of a tumor and its location within the brain, as well as characteristics that help to differentiate one type of tumor from another.
For example, brainmetastasestend to be located near small blood vessels, where tumor cells are more likely to cross the blood-brain barrier. Another type of brain tumor, glioblastoma multiforme, tends to be a large tumor that spreads across several different areas of the brain. A brain tumor called anoligodendrogliomamay have bright spots on a brain CT scan due to calcium deposits within the brain.
The most common imaging tests for brain tumors aremagnetic resonance imaging(MRI)andcomputed tomography (CAT scan, CT scan).These tests are usually done with injected contrast material, which is fluid that surrounds solid areas, such as brain tumors, to better define the edges.
Other tests often used for research purposes and sometimes surgical planning includemagnetic resonance spectroscopy (MRS)andfunctional MRI (fMRI), which detect differences in metabolic activity that may occur with a brain tumor. A diffusion-weighted image uses MRI linked to software that calculates changes in the diffusion of water, which also may be altered when someone has a brain tumor.
Similarly, apositron emission test(PET)is similar to a CT scan and can detect microscopic changes in blood flow and oxygen consumption, which may occur with some brain tumors.
These types of imaging tests may not be available in every hospital, and the results are not considered as reliable or consistent in brain tumor diagnosis as contrast-enhanced brain CT or brain MRI, but they are valuable because they detect subtle changes that scientists use to learn more about brain disease.
Some other imaging tests can be used in surgical planning. For example, anangiogramuses CT, ultrasound or MRI to observe blood vessels, and can be used so that your surgeon can see if the tumor is near a blood vessel.
There are at least 30 different types of brain tumors, and each type has a different appearance on imaging tests, prognosis, and recommended treatment.
Some of the most common types/descriptions of tumors include:
Blood tests can also help in assessing some types of brain tumors, and a lumbar puncture may help in diagnosing metastatic (aggressively spreading) tumors in the brain. A biopsy is a major procedure, and it is the most definitive test for brain tumor diagnosis.
Hormone Blood Tests
Some brain tumors, such as pituitary tumors, can produce hormones that are detected in the blood. If you have a pituitary tumor, you may have an abnormal concentration of hormones such as growth hormone or thyrotropin (a hormone that stimulates the thyroid gland) in your blood.These are not routine tests, so your healthcare provider would only order them if there is a high suspicion of a hormone-producing brain tumor.
Lumbar Puncture (LP)
For this test, commonly referred to as a spinal tap, a healthcare provider extracts fluid from your lower spine using a needle, which is then tested. It can help identify infections, inflammation, or cancer cells.
However, LP is not usually a reliable test when it comes to the evaluation of brain cancer because cancer cells may or may not appear in the CSF.
If you have possible brain cancer, your healthcare provider may decide against an LP if the brain tumor appears large on imaging studies. The alteration of fluid flow that results from an LP can cause dangerous movements in the brain itself if you have a large brain tumor.
Biopsy
A biopsy is a sample of tissue taken for examination under a microscope, and you may need one based on the results of your imaging studies.
Usually, brain tumor type can be determined based on imaging tests. When a tumor appears to be metastatic, a biopsy can be done to identify the tissue from which it came.
A biopsy is also used for grading primary brain tumors from grade I to grade IV. Low-grade brain tumors are considered less aggressive than high-grade ones.A pathologist can estimate the tumor’s predicted rate of growth and likelihood of invasion based on characteristics in the appearance of the cells under a microscope.
A brain tumor biopsy requires a surgical procedure under general anesthesia, usually involving the removal of a section of the skull to access the brain tissue. Because a biopsy is no less invasive than brain surgery, your healthcare providers will try to remove the whole tumor during a biopsy procedure so that you will not need another surgery if possible.
It will take several weeks to recover from a brain biopsy, even if the sample is small. There is arisk of bleedingor swelling in the brain after the procedure, and your team will closely monitor you for neurological changes after your biopsy.
A brain tumor can cause symptoms that are similar to those of other conditions. Your diagnostic evaluation can differentiate between a brain tumor and another neurological condition that may initially manifest in similar ways.
Frequently Asked QuestionsIf a brain tumor is suspected following a physical exam and areview of symptoms, the healthcare provider will typically order a magnetic resonance imaging (MRI) scan of the brain. If a mass is found, a biopsy procedure may be needed to remove a sample of the tissue to check for cancer cells.During the physical exam, the healthcare provider will perform a visual field test to check the person’s vision. Changes in vision—including blurring, dark spots, double vision, ortunneling—may be a sign that a tumor has damaged or is pressing on a part of the brain that facilitates eyesight.A brain tumor can affect cognitive function, movement, reflexes, and coordination as it damages or disrupts certain parts of the brain. A series of in-office neurological tests (called a “neuro exam”) may not only suggest that a brain tumor is involved but also where it is located.Lab tests cannot diagnose a brain tumor, but they may suggest that cancer is involved based on substances found in the blood orcerebrospinal fluid (CSF). Referred to as tumor makers, these substances include hormones, proteins, and chromosomes that may be specific to one type of cancer or several.Generally yes, but the location of the tumor may make a biopsy impossible. In some cases, the characteristics of a tumor may be obvious enough (such as anastrocytomaon the brain stem) that a biopsy is not needed. In others, a PET scan or MR spectrometry along with other tests may provide enough information to make a diagnosis.A liquid biopsy is a newer technique that looks for pieces of DNA from a tumor in a sample of blood. It is an evolving technology with significant limitations, but some studies suggest that it may be useful in detecting malignantglioma(a type of brain cancer) and even differentiate between less aggressive and more aggressive forms of the disease.Learn MoreHow a Liquid Biopsy Is UsedMetastasis(the spread of cancer beyond theprimary tumor) may first be detected if cancer cells are found in cerebrospinal fluid obtained in alumbar puncture. An MRI with contrast dye is the tool commonly used to diagnose metastases and determine how far and where cancer has spread throughout the body.
If a brain tumor is suspected following a physical exam and areview of symptoms, the healthcare provider will typically order a magnetic resonance imaging (MRI) scan of the brain. If a mass is found, a biopsy procedure may be needed to remove a sample of the tissue to check for cancer cells.
During the physical exam, the healthcare provider will perform a visual field test to check the person’s vision. Changes in vision—including blurring, dark spots, double vision, ortunneling—may be a sign that a tumor has damaged or is pressing on a part of the brain that facilitates eyesight.
A brain tumor can affect cognitive function, movement, reflexes, and coordination as it damages or disrupts certain parts of the brain. A series of in-office neurological tests (called a “neuro exam”) may not only suggest that a brain tumor is involved but also where it is located.
Lab tests cannot diagnose a brain tumor, but they may suggest that cancer is involved based on substances found in the blood orcerebrospinal fluid (CSF). Referred to as tumor makers, these substances include hormones, proteins, and chromosomes that may be specific to one type of cancer or several.
Generally yes, but the location of the tumor may make a biopsy impossible. In some cases, the characteristics of a tumor may be obvious enough (such as anastrocytomaon the brain stem) that a biopsy is not needed. In others, a PET scan or MR spectrometry along with other tests may provide enough information to make a diagnosis.
A liquid biopsy is a newer technique that looks for pieces of DNA from a tumor in a sample of blood. It is an evolving technology with significant limitations, but some studies suggest that it may be useful in detecting malignantglioma(a type of brain cancer) and even differentiate between less aggressive and more aggressive forms of the disease.Learn MoreHow a Liquid Biopsy Is Used
A liquid biopsy is a newer technique that looks for pieces of DNA from a tumor in a sample of blood. It is an evolving technology with significant limitations, but some studies suggest that it may be useful in detecting malignantglioma(a type of brain cancer) and even differentiate between less aggressive and more aggressive forms of the disease.
Learn MoreHow a Liquid Biopsy Is Used
Metastasis(the spread of cancer beyond theprimary tumor) may first be detected if cancer cells are found in cerebrospinal fluid obtained in alumbar puncture. An MRI with contrast dye is the tool commonly used to diagnose metastases and determine how far and where cancer has spread throughout the body.
9 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institute of Neurological Disorders and Stroke.Brain and spinal cord tumors: hope through research.American Cancer Society.Tests for brain and spinal cord tumors in adults.American Cancer Society.What are pituitary tumors?.Le Rhun E, Taillibert S, Chamberlain MC.Carcinomatous meningitis: leptomeningeal metastases in solid tumors.Surg Neurol Int. 2013;4(Suppl 4):S265–S288. doi:10.4103/2152-7806.111304American Cancer Society.Types of brain and spinal cord tumors in adults.Patel K, Clifford DB.Bacterial brain abscess.Neurohospitalist. 2014;4(4):196–204. doi:10.1177/1941874414540684Sefi-Yurdakul N.Visual findings as primary manifestations in patients with intracranial tumors.Int J Ophthalmol. 2015;8(4):800-803. doi:10.3980/j.issn.2222-3959.2015.04.28Nayak L, DeAngelis LM, Brandes AA, et al.The Neurologic Assessment in Neuro-Oncology (NANO) scale: a tool to assess neurologic function for integration into the Response Assessment in Neuro-Oncology (RANO) criteria.Neuro Oncol. 2017;19(5):625-635. doi:10.1093/neuonc/nox029Soffietti R, Abacioglu U, Baumert B, et al.Diagnosis and treatment of brain metastases from solid tumors: guidelines from the European Association of Neuro-Oncology (EANO).Neuro Oncol. 2017;19(2):162-74. doi:10.1093/neuonc/now241
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institute of Neurological Disorders and Stroke.Brain and spinal cord tumors: hope through research.American Cancer Society.Tests for brain and spinal cord tumors in adults.American Cancer Society.What are pituitary tumors?.Le Rhun E, Taillibert S, Chamberlain MC.Carcinomatous meningitis: leptomeningeal metastases in solid tumors.Surg Neurol Int. 2013;4(Suppl 4):S265–S288. doi:10.4103/2152-7806.111304American Cancer Society.Types of brain and spinal cord tumors in adults.Patel K, Clifford DB.Bacterial brain abscess.Neurohospitalist. 2014;4(4):196–204. doi:10.1177/1941874414540684Sefi-Yurdakul N.Visual findings as primary manifestations in patients with intracranial tumors.Int J Ophthalmol. 2015;8(4):800-803. doi:10.3980/j.issn.2222-3959.2015.04.28Nayak L, DeAngelis LM, Brandes AA, et al.The Neurologic Assessment in Neuro-Oncology (NANO) scale: a tool to assess neurologic function for integration into the Response Assessment in Neuro-Oncology (RANO) criteria.Neuro Oncol. 2017;19(5):625-635. doi:10.1093/neuonc/nox029Soffietti R, Abacioglu U, Baumert B, et al.Diagnosis and treatment of brain metastases from solid tumors: guidelines from the European Association of Neuro-Oncology (EANO).Neuro Oncol. 2017;19(2):162-74. doi:10.1093/neuonc/now241
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Institute of Neurological Disorders and Stroke.Brain and spinal cord tumors: hope through research.American Cancer Society.Tests for brain and spinal cord tumors in adults.American Cancer Society.What are pituitary tumors?.Le Rhun E, Taillibert S, Chamberlain MC.Carcinomatous meningitis: leptomeningeal metastases in solid tumors.Surg Neurol Int. 2013;4(Suppl 4):S265–S288. doi:10.4103/2152-7806.111304American Cancer Society.Types of brain and spinal cord tumors in adults.Patel K, Clifford DB.Bacterial brain abscess.Neurohospitalist. 2014;4(4):196–204. doi:10.1177/1941874414540684Sefi-Yurdakul N.Visual findings as primary manifestations in patients with intracranial tumors.Int J Ophthalmol. 2015;8(4):800-803. doi:10.3980/j.issn.2222-3959.2015.04.28Nayak L, DeAngelis LM, Brandes AA, et al.The Neurologic Assessment in Neuro-Oncology (NANO) scale: a tool to assess neurologic function for integration into the Response Assessment in Neuro-Oncology (RANO) criteria.Neuro Oncol. 2017;19(5):625-635. doi:10.1093/neuonc/nox029Soffietti R, Abacioglu U, Baumert B, et al.Diagnosis and treatment of brain metastases from solid tumors: guidelines from the European Association of Neuro-Oncology (EANO).Neuro Oncol. 2017;19(2):162-74. doi:10.1093/neuonc/now241
National Institute of Neurological Disorders and Stroke.Brain and spinal cord tumors: hope through research.
American Cancer Society.Tests for brain and spinal cord tumors in adults.
American Cancer Society.What are pituitary tumors?.
Le Rhun E, Taillibert S, Chamberlain MC.Carcinomatous meningitis: leptomeningeal metastases in solid tumors.Surg Neurol Int. 2013;4(Suppl 4):S265–S288. doi:10.4103/2152-7806.111304
American Cancer Society.Types of brain and spinal cord tumors in adults.
Patel K, Clifford DB.Bacterial brain abscess.Neurohospitalist. 2014;4(4):196–204. doi:10.1177/1941874414540684
Sefi-Yurdakul N.Visual findings as primary manifestations in patients with intracranial tumors.Int J Ophthalmol. 2015;8(4):800-803. doi:10.3980/j.issn.2222-3959.2015.04.28
Nayak L, DeAngelis LM, Brandes AA, et al.The Neurologic Assessment in Neuro-Oncology (NANO) scale: a tool to assess neurologic function for integration into the Response Assessment in Neuro-Oncology (RANO) criteria.Neuro Oncol. 2017;19(5):625-635. doi:10.1093/neuonc/nox029
Soffietti R, Abacioglu U, Baumert B, et al.Diagnosis and treatment of brain metastases from solid tumors: guidelines from the European Association of Neuro-Oncology (EANO).Neuro Oncol. 2017;19(2):162-74. doi:10.1093/neuonc/now241
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