Diagnosis
If you have symptoms that suggest a brain tumor,
your doctor will give you a physical exam and ask
about your personal and family health history. You may
have one or more of the following tests:
- Neurologic exam: Your doctor checks your vision,
hearing, alertness, muscle strength, coordination,
and reflexes. Your doctor also examines your eyes to
look for swelling caused by a tumor pressing on the
nerve that connects the eye and the brain.
- MRI: A large machine with a strong magnet linked
to a computer is used to make detailed pictures of
areas inside your head. Sometimes a special dye
(contrast material) is injected into a blood vessel in
your arm or hand to help show differences in the
tissues of the brain. The pictures can show abnormal
areas, such as a tumor.
- CT scan: An x-ray machine linked to a computer
takes a series of detailed pictures of your head. You
may receive contrast material by injection into a
blood vessel in your arm or hand. The contrast
material makes abnormal areas easier to see.
Your doctor may ask for other tests:
- Angiogram: Dye injected into the bloodstream
makes blood vessels in the brain show up on an
x-ray. If a tumor is present, the x-ray may show the
tumor or blood vessels that are feeding into the
tumor.
- Spinal tap: Your doctor may remove a sample of
cerebrospinal fluid (the fluid that fills the spaces in
and around the brain and spinal cord). This
procedure is performed with local anesthesia. The
doctor uses a long, thin needle to remove fluid from
the lower part of the spinal column. A spinal tap
takes about 30 minutes. You must lie flat for several
hours afterward to keep from getting a headache. A
laboratory checks the fluid for cancer cells or other
signs of problems.
- 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 can show cancer, tissue changes that
may lead to cancer, and other conditions. A biopsy is
the only sure way to diagnose a brain tumor, learn
what grade it is, and plan treatment.
Surgeons can obtain tissue to look for tumor cells in
two ways:
- Biopsy at the same time as treatment: The
surgeon takes a tissue sample when you have
surgery to remove part or all of the tumor. See the
Surgery section.
- Stereotactic biopsy: You may get local or
general anesthesia and wear a rigid head frame for this
procedure. The surgeon makes a small incision in
the scalp and drills a small hole (a burr hole) into
the skull. CT or MRI is used to guide the needle
through the burr hole to the location of the tumor.
The surgeon withdraws a sample of tissue with
the needle. A needle biopsy may be used when a
tumor is deep inside the brain or in a part of the
brain that can't be operated on.
However, if the tumor is in the brain stem or certain
other areas, the surgeon may not be able to remove
tissue from the tumor without harming normal brain
tissue. In this case, the doctor uses MRI, CT, or
other imaging tests to learn as much as possible
about the brain tumor.
A person who needs a biopsy may want to ask
the doctor the following questions:
- Why do I need a biopsy? How will the biopsy
results affect my treatment plan?
- What kind of biopsy will I have?
- How long will it take? Will I be awake? Will it
hurt?
- What are the chances of infection or bleeding
after the biopsy? Are there any other risks?
- How soon will I know the results?
- If I do have a brain tumor, who will talk with
me about treatment? When?
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