title: Presenting signs and symptoms in brain tumors.
abstract: Focal symptoms and signs occurring during brain tumor clinical presentation are dependent on a number of factors. Location and rate of growth are the most critical, followed by overall lesion size and nature, whether infiltrating or causing the displacement of neural structures, but also the presence or extent of associated pathology, including edema, hemorrhage, vascular compromise, and cerebrospinal fluid obstruction. Mechanisms of presenting symptomatology can be divided into tumor and peritumoral factors. Tumor factors include histology, for example, in that seizures are common in patients with certain low-grade gliomas. Peritumoral factors, including regional hypoxia and ionic changes in the peritumoral zone, may influence neuronal activity and extracellular glutamate may be associated with neuronal hyperexcitability. Blood-brain barrier breakdown may predispose to seizure and localized neuronal dysfunction. Finally, signs and symptoms in brain tumors can be generalized, associated with increased intracranial brain pressure, but can also be localized, based on the involvement of the major structures of the central nervous system.
authors.affiliation: Department of Neurology 2, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Inserm Experimental Neuro-Oncology Laboratory, Institut du Cerveau et de la Moelle, Université Pierre et Marie Curie, Paris, France.
authors.forename: Agusti
authors.initials: A
authors.lastname: Alentorn
authors.affiliation: Department of Neurology 2, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Inserm Experimental Neuro-Oncology Laboratory, Institut du Cerveau et de la Moelle, Université Pierre et Marie Curie, Paris, France. Electronic address: khe.hoang-xuan@psl.aphp.fr.
authors.forename: Khê
authors.initials: K
authors.lastname: Hoang-Xuan
authors.affiliation: Hermelin Brain Tumor Center and Departments of Neurology and Neurosurgery, Henry Ford Hospital, Detroit, MI, USA; Wayne State University, Detroit, MI, USA.
authors.forename: Tom
authors.initials: T
authors.lastname: Mikkelsen
mesh_terms: D001812:Blood-Brain Barrier / Q000503:physiopathology; D001932:Brain Neoplasms / Q000145:classification / Q000473:pathology* / Q000503:physiopathology*; D003072:Cognition Disorders / Q000209:etiology; D006801:Humans; D019586:Intracranial Hypertension / Q000150:complications / Q000209:etiology*; D012640:Seizures / Q000209:etiology
keywords: altered mental status; headache; herniation syndromes; increased intracranial pressure; seizure