Brain Tumor - Diagnosis

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Written by Dr. Sangamithra, MBBS | Medically Reviewed by Dr. Ramya Ananthakrishnan, MD on Apr 25, 2018
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Brain Tumor - Diagnosis

The first step in diagnosing brain cancer involves evaluating symptoms and taking a medical history. If there is any indication that there may be a brain tumor, various tests are done to confirm the diagnosis.

  • The diagnosis is done by either a neurologist (a specialist in brain and nerve disorders) or an oncologist (a doctor who specializes in cancer treatment) who both check for physical signs
  • Nervous system examination: The doctors check the nerves or the brain which control the eyes and face, check for equal strength and sensation on both sides of the body, coordination and balance, and memory and judgment.
  • Mental exercises, such as simple arithmetic and simple questions.
  • An eye examination using an ophthalmoscope (instrument which shines a light at the back of the eye). This test is done to see if the optic disc at the back of the eye is swollen. A swollen optic disc is known as papilloedema and is a sign of raised intracranial pressure due to the growing brain tumor.
  • Hearing tests.
  • Facial muscle tests - smiling, grimacing.
  • Tongue movement is also tested.
  • Checking the strength of your arms and legs, knee jerks and other reflexes.
  • The doctor will test one's ability to feel sensations like pin pricks on areas of skin, to tell the difference between hot and cold and possibly to recognize the feeling and shape of familiar objects like coins.
  • Gait of the patient is noted.
  • Routine laboratory tests may be performed such as analysis of blood, electrolytes, liver function tests, and a blood coagulation profile. Blood or urine tests may be done to detect drug use.
  • CT scan: An X-ray machine linked to a computer takes a series of detailed pictures of the head. The patient may receive an injection of a special dye so the brain shows up clearly in the pictures. The pictures can show tumors in the brain.
  • MRI: A powerful magnet linked to a computer makes detailed pictures of areas inside the body. These pictures are viewed on a monitor and can also be printed. Sometimes a special dye is injected to help show differences in the tissues of the brain. The pictures can show a tumor or other problem in the brain.
  • Positron emission tomography (PET scan): It helps the physician evaluate brain function and cell growth by producing images of physical and chemical changes in the brain. PET can precisely locate a tumor and detect metastatic and recurrent brain cancer at earlier stages than MRI or CT scan. This technique also can be used to evaluate the tumor's response to chemotherapy and radiation treatment.
  • Angiogram: Dye injected into the bloodstream flows into the blood vessels in the brain to make them show up on an x-ray. If a tumor is present, the doctor may be able to see it on the x-ray.
  • Skull x-ray: Some types of brain tumors cause calcium deposits in the brain or changes in the bones of the skull. With an x-ray, the doctor can check for these changes.
  • Spinal tap: The doctor may remove a sample of cerebrospinal fluid with local anesthesia. The doctor uses a long, thin needle to remove fluid from the spinal column. A laboratory checks the fluid for cancer cells or other signs of problems.
  • Myelogram: This is an x-ray of the spine. A spinal tap is performed to inject a special dye into the cerebrospinal fluid. The patient is tilted to allow the dye to mix with the fluid. This test helps the doctor detect a tumor in the spinal cord.
  • Biopsy: The removal of tissue to look for tumor cells is called a biopsy. A pathologist looks at the cells under a microscope to check for abnormal cells. A biopsy is the only sure way to diagnose a brain tumor. the three ways of obtaining the tissue samples are:
  • Needle biopsy: The surgeon makes a small incision in the scalp and drills a small hole into the skull. This is called a burr hole. The doctor passes a needle through the burr hole and removes a sample of tissue from the brain tumor.
  • Stereotactic biopsy: An imaging device, such as CT or MRI, guides the needle through the burr hole to the location of the tumor. The surgeon withdraws a sample of tissue with the needle.
  • Biopsy at the same time as treatment: The surgeon takes a tissue sample when the patient has surgery to remove the tumor.

Brain Tumor - References

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zzshell

My Mother in Law just had part of her brain tumor removed about a month ago. Since then she can not hold a normal conversation. It is like random things about her past and childhood. But its the same story everyday throughout the entire day. Is this a permanent side effect or will this fade as she gets better...

palomita_2015

How do you know if you have a brain tumor or if its a normal thing at the age of 14?

BigPete

My brother had a tumor removed a year ago. He seems to be doing fine some days and not so good other. After reading comments that other people have left, my brother is going through the same thing except he is seeing several doctors and everyone of them is treating him for something different, depression, steroids, thyroid,headache, parcason, ect. These are the things he is telling me?? I not so convince on all the drugs he is on but I'm not a doc. Is anyone else on a lot of drug?? Thanks

LovingU

I had a tumor of cancer removed from my brain 3 yrs ago and I have so many doctors and I take a lot of medications because I have all of them problems and fibromyigia then some. I don't like it all because i'm only 24 and it seems like I'm about 50. I know it seems unreal to you but it is just about ture.

Hi, my brother has a brain tumor. He lives in Ethipoia. The doctors said the tumor is 7 inch long and he is in a critical condition. I am working on the process to bring him here and to get a better help. However, after the doctors told him the side effects after the surgery, my brother refused to have the surgery. Please give me your comments on how I can help him to decide to have the surgery.

My younger cousin aged 18 yrs suffering from the brain tumor from last one year.Currently he is admitted into Inlacs Budrani hospital,Pune.He has diagnosed with the brain tumor situated just above the neck at the back of forehead. The doctors started the radiation therapy one year ago from 1st sept to 30 th oct 2011. After 5/6 months his brain got swelled beacause of the radation effect for which the doctors did a surgery in which they removed some part of skull so that the swelled brain should fit in the space. After 2/3 months again he is now suffering in which he can't swallow any food even his saliva so the doctors now have placed a tube inside his throat so that he can now survive on the liquid directly poured into it. Pls advice me some further medicatgion as we are uncertain about his health.He is again now admitted in the hospital and is under observation.

kuldeep13984

my mother had brain surgery almost 2 month ago and she is still suffering from pain and dizziness sometime she not even recognize us. her one hand and leg not working now and now week ago she fall down on the floor injured herself. i am really worried i don't know what to do doc says it takes time to recover i don't know how much

Clozano88

My mom had her tumor removed 3years ago an she still hasn't fully recovered. The doctor and a naturalist say that the tingly sensation On her surgery side will not stop until around 5 yrs cause that's when the Anastasia completely leave her brain. Just today she blanked out at the for a good 10 min and was mummbling jibber ish…I believe that everyone has different side effect and you just got to help her out. Just take it day by day cause it's a long healing process.

YonnaCMA

My mom also had brain surgery. She has had 2 actually. But she is doin fine for teh most part. She still has a little bit of short term meomory loss, and she may still get servere headaches, but for the most part she is doing very well. So like she said just take it one day at a time and also prayer works!

My mother was diagnosed with the worst case of glioma and she also had surgery to remove the tumor. After surgery the recuperation was brutal since she was dizzy all the time ans nauseas...She also fell a couple of time out of the bed and her last fall brought her to the emergency room and after 2 weeks of the fall she died.

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