This information has been reviewed by:
Dr Kate Drummond, Neurosurgeon, Royal Melbourne Hospital
Dr Peter New, Head, Spinal Rehabilitation Unit, Caulfield General Medical Centre and lecturer, Monash University Departments of Medicine and Epidemiology and Preventative Medicine
Symptoms of spinal cord tumours
Doctors and other health professionals you may see
How a brain or spinal cord tumour is diagnosed
Computerised tomography (CT) scan
Magnetic resonance imaging (MRI)
Symptoms of tumours of the central nervous system vary, depending on what part of the brain or spinal cord a tumour presses on. Sometimes, when a tumour develops slowly, the symptoms develop so gradually that they are hardly noticed.
Headaches are often the first symptom of a brain tumour. They are due to increased pressure inside the skull. This may occur because of the presence of the tumour itself and/or because the tumour has caused the normal brain around it to swell with fluid. Headaches caused by brain tumours can be mild, severe, persistent, or come and go. Both benign and malignant brain tumours may cause headaches. Other symptoms include:
There are four cavities in the brain which are filled with cerebrospinal fluid. The fluid flows through narrow passages between the cavities and the surface of the brain. Occasionally this flow can be blocked by a brain tumour. When this happens the fluid builds up and raises the pressure on the brain. This is called hydrocephalus and it is common in children with brain tumours.
Pain in the back is a common symptom, as the tumour presses on the spinal cord in its narrow space within the spinal column. Loss of feeling, muscle weakness and loss of movement in legs and arms may follow. Most back pain, however, is due to other, much less serious, spinal disease.
A very distressing symptom is difficulty with going to the toilet. This may be an inability to use your bowels or pass urine and incontinence of bowels and/or bladder is also possible.Your doctor will examine you and refer you for tests to see if you have cancer. This can be a worrying and tiring time, especially if you need to have several tests.
If the tests show you have or may have cancer, your doctor will refer you to a specialist. You may have further tests and then the specialist will advise you about treatment options.
Specialists and other health professionals who care for people with brain and spinal cord tumours include:Your doctor will take a detailed history of your symptoms and examine you thoroughly. If a central nervous system tumour is suspected, you will be referred to a neurologist or neurosurgeon. The specialist will check how different parts of your brain are functioning. This may include checking your reflexes (for example, your knee-jerks), the strength in the muscles of your arms and legs, and your ability to feel pin-pricks and to distinguish between hot and cold on your skin. You may be asked to do some mental exercises, such as some simple maths.
The doctor will also probably look into your eyes using an ophthalmoscope, to see the end of your optic nerve. This nerve connects the eye directly to the brain and it may bulge if the pressure in your skull is raised, for example by a tumour.
If a spinal cord tumour is suspected, you will need to have x-rays of the affected spinal areas. The doctor may order a magnetic resonance imaging (MRI) scan and computerised tomography (CT) scan.
MRI and CT scans are also the two main tests used to detect brain tumours and help the doctors to plan the best treatment for you.
A CT scan is a type of x-ray. It gives across-sectional picture of the organs and other structures (including any tumours) in your body.
CT scans are usually done at a hospital or a radiology clinic. It takes about 30 to 40 minutes to complete this painless test.
You will be asked not to eat or drink before the scan. A dye will be injected (or swallowed if you are having a full body scan), so anything unusual will show more clearly. You will be asked to lie on a table, which is moved into the CT scanner, which is large and round like a doughnut and moves around you. Most people are able to go home as soon as their scan is over.
There is a small possibility of the injected dye causing an allergic reaction. You should tell your doctor if you are allergic to iodine or to contrast dyes, or if you are diabetic or have abnormal kidney function.
Like a CT scan, MRI is painless, and the magnetic field is harmless. You will be asked to lie on a table inside a large metal tube, which is open at both ends. The test may take up to an hour. The tube makes some people feel claustrophobic (afraid of being in a small space). If you think you are likely to feel this way, please tell the treatment centre in advance: you may be able to take someone into the room with you for support. The machine can be quite noisy.
You will also have dye inserted into one or your veins so anything unusual will show more clearly. Because the MRI scanner uses a powerful magnet, people with certain types of metal in their bodies should not have MRI scans. You should tell your doctor if you have any metal objects in your body (like a pace-maker), or clips from past operations, or (for example) if you have had injuries to the eyes or elsewhere caused by metal. You will also need to remove all metal jewellery.
This test is used sometimes in people with tumours, usually meningiomas.
You will have an injection of dye into an artery, often in your groin. X-rays will be taken as the dye flows through the blood vessels of the brain. This will show up the position of the tumour and the blood vessels supplying it.
This assists the surgeon and may also allow the blood vessels supplying the tumour to be blocked before the operation. This is called embolisation.
Other tests which are sometimes used to diagnose tumours of the brain and spinal cord are:
If your doctor recommends these or any other tests, ask them to explain the tests before you have them. Understanding what is in store can help to relieve some of the anxiety you may feel before having a test.
