A brain tumour is an abnormal growth of cells inside the skull. Primary tumours start in the brain or its coverings and may be benign, such as most meningiomas, pituitary adenomas and schwannomas, or malignant, such as glioblastoma. Secondary tumours (metastases) have spread from a cancer elsewhere, most often lung, breast, melanoma or kidney, and are more common than primary ones in adults.
Tumours are classified by cell type, by WHO grade from 1 to 4 and increasingly by molecular markers, which now weigh heavily in both outlook and treatment. Even a benign tumour can be serious if it presses on a critical structure, and some small ones need nothing more than monitoring.
Symptoms
- A new seizure in an adult
- Headaches that are new, progressively worsening, worse in the morning or on coughing, particularly with nausea or vomiting
- Gradual weakness, numbness or clumsiness on one side
- Changes in personality, memory or concentration noticed by family
- Speech or comprehension difficulty
- Blurred or double vision, or loss of part of the visual field
- Unsteadiness, or hearing loss in one ear
- Hormonal symptoms such as missed periods, milk discharge or changes in hands and face with pituitary tumours
- Drowsiness as pressure rises
Causes and risk factors
For most primary brain tumours no cause is identified. The established risk factors are previous radiotherapy to the head and rare inherited syndromes: neurofibromatosis types 1 and 2, Li-Fraumeni syndrome, tuberous sclerosis, von Hippel-Lindau disease and Lynch syndrome. Incidence rises with age, though certain tumour types are particular to childhood. A weakened immune system increases the risk of brain lymphoma. Large studies have not shown that mobile phones, power lines or head injury cause brain tumours.
How it is diagnosed
- MRI with contrast: The key test, with perfusion, spectroscopy and functional sequences added to estimate grade and map areas controlling speech and movement.
- CT scan: Often the first scan in an emergency; also shows calcification and bone involvement.
- Body imaging: CT of chest, abdomen and pelvis or PET-CT when metastasis is suspected.
- Biopsy or resection: Tissue is essential for diagnosis, obtained by stereotactic needle biopsy or at open surgery.
- Molecular pathology: IDH mutation, 1p/19q codeletion, MGMT methylation and other markers define the tumour type under the WHO 2021 classification and predict response to treatment.
- Hormone tests and visual fields: For tumours in the pituitary region.
- Neuropsychological and language assessment: A baseline before surgery in eloquent areas.
Treatment options
- Observation with serial MRI: For small meningiomas or low grade lesions found by chance that cause no symptoms.
- Surgical removal: Craniotomy using neuronavigation, intraoperative monitoring, fluorescence guidance and awake mapping where needed, aiming for the maximal safe resection.
- Endoscopic transnasal surgery: For pituitary and some skull base tumours, with no external incision.
- Radiotherapy: Fractionated treatment over up to 6 weeks for gliomas; planned to spare healthy brain.
- Stereotactic radiosurgery: Gamma Knife, CyberKnife or linear accelerator based, in 1 to 5 sessions, for metastases, small meningiomas and schwannomas.
- Chemotherapy and targeted therapy: Temozolomide with radiotherapy for glioblastoma, PCV for oligodendroglioma, vorasidenib for IDH-mutant low grade glioma, and targeted or immune drugs for metastases according to the primary cancer.
- Tumour treating fields: A wearable device used with temozolomide for glioblastoma in some countries.
- Supportive care: Dexamethasone for swelling, anti-seizure medicine when seizures have occurred, rehabilitation and palliative care input.
When it is urgent
Go to a local emergency department for a first seizure, or one lasting more than 5 minutes, sudden severe headache with vomiting, rapidly increasing drowsiness or confusion, sudden weakness or loss of vision. Rising pressure in the skull can become life-threatening within hours and must be treated where you are.
Travelling to Türkiye for treatment
Much of brain tumour care is planned and can reasonably involve travel: a second opinion on imaging and pathology, surgery at a high-volume neurosurgical unit (typically 10 to 14 days including recovery before the flight) or radiosurgery (2 to 4 days). Six weeks of radiotherapy with chemotherapy, and the years of MRI surveillance that follow, are better arranged at home, so agree in advance who will take over. Flying is usually possible 1 to 2 weeks after uncomplicated surgery once air inside the skull has resolved; your surgeon will confirm. Driving rules after seizures or brain surgery differ by country.
Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.
الأسئلة المتكررة
Are all brain tumours cancer?
No. About two thirds of primary brain tumours in adults are benign or low grade. They can still cause harm by pressure and may need treatment.
Can a tumour be removed completely?
Often for meningiomas and schwannomas. Gliomas infiltrate normal brain, so the aim is maximal safe removal followed by further treatment as the grade requires.
What is awake surgery?
For tumours near speech or movement areas, you are woken during part of the operation to perform tasks while the surgeon maps function. The brain itself feels no pain.
Do most headaches mean a tumour?
No. Headache on its own, without other neurological symptoms, is very rarely due to a tumour.
Will I need anti-seizure medication?
Only if you have had a seizure. Preventive use in people who have never had one is not recommended beyond the period around surgery.