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Brain tumor
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==Signs and symptoms== The signs and symptoms of brain tumors are broad. People may experience symptoms regardless of whether the tumor is benign (not cancerous) or [[Malignancy|cancerous]].<ref>{{Cite web|url=http://www.merckmanuals.com/home/brain,-spinal-cord,-and-nerve-disorders/tumors-of-the-nervous-system/brain-tumors|title=Brain Tumors|access-date=2 August 2016|url-status=live|archive-url=https://web.archive.org/web/20160812032003/http://www.merckmanuals.com/home/brain,-spinal-cord,-and-nerve-disorders/tumors-of-the-nervous-system/brain-tumors|archive-date=12 August 2016}}</ref> Primary and secondary brain tumors present with similar symptoms, depending on the location, size, and rate of growth of the tumor.<ref name="abta.org">{{Cite web|url=http://www.abta.org/brain-tumor-information/symptoms/mood-swings.html|title=Mood Swings and Cognitive Changes {{!}} American Brain Tumor Association|website=abta.org|access-date=3 August 2016|url-status=dead|archive-url=https://web.archive.org/web/20160802203516/http://www.abta.org/brain-tumor-information/symptoms/mood-swings.html|archive-date=2 August 2016}}</ref> For example, larger tumors in the frontal lobe can cause changes in the ability to think. However, a smaller tumor in an area such as [[Wernicke's area]] (small area responsible for language comprehension) can result in a greater loss of function.<ref>{{Cite web|url=http://www.brainsciencefoundation.org/bUnderstandbPrimaryBrainTumors/AdditionalResources/CopingWithPersonalityBehavioralChanges/tabid/283/Default.aspx|title=Coping With Personality & Behavioral Changes|website=brainsciencefoundation.org|access-date=3 August 2016|url-status=live|archive-url=https://web.archive.org/web/20160730063637/http://www.brainsciencefoundation.org/bUnderstandbPrimaryBrainTumors/AdditionalResources/CopingWithPersonalityBehavioralChanges/tabid/283/Default.aspx|archive-date=30 July 2016}}</ref> ===Headaches {{anchor|Headache}}=== Headaches as a result of raised [[intracranial pressure]] can be an early symptom of brain cancer.<ref name=":0">{{cite journal | vauthors = Kahn K, Finkel A | title = It IS a tumor -- current review of headache and brain tumor | journal = Current Pain and Headache Reports | volume = 18 | issue = 6 | pages = 421 | date = June 2014 | pmid = 24760490 | doi = 10.1007/s11916-014-0421-8 | s2cid = 5820118 }}</ref> However, isolated headache without other symptoms is rare, and other symptoms including visual abnormalities may occur before headaches become common.<ref name=":0" /> Certain warning signs for headache exist which make the headache more likely to be associated with brain cancer.<ref name=":0" /> These are defined as "abnormal neurological examination, headache worsened by [[Valsalva maneuver]], headache causing awakening from sleep, new headache in the older population, progressively worsening headache, atypical headache features, or patients who do not fulfill the strict definition of migraine".<ref name=":0" /> Other associated signs are headaches that are worse in the morning or that subside after vomiting.<ref>{{Cite web|date=2020-11-19|title=Nosebleeds & Headaches: Do You Have Brain Cancer?|url=https://ana-neurosurgery.com/symptoms-brain-tumor/|access-date=2020-11-26|website=Advanced Neurosurgery Associates|language=en-US}}</ref> ===Location-specific symptoms=== [[File:Brain headBorder.jpg|thumb|upright=1.3|The main areas of the brain and [[limbic system]]]] The brain is divided into lobes and each lobe or area has its own function.<ref name=":02">{{cite journal |last1=Gregg |first1=N. |last2=Arber |first2=A. |last3=Ashkan |first3=K. |last4=Brazil |first4=L. |last5=Bhangoo |first5=R. |last6=Beaney |first6=R. |last7=Gullan |first7=R. |last8=Hurwitz |first8=V. |last9=Costello |first9=A. |last10=YΓ‘gΓΌez |first10=L |title=Neurobehavioural changes in patients following brain tumour: patients and relatives perspective |journal=Supportive Care in Cancer |date=November 2014 |volume=22 |issue=11 |pages=2965β2972 |doi=10.1007/s00520-014-2291-3 |pmid=24865878 }}</ref><ref name=":1">{{Cite web|url=http://www.brainsciencefoundation.org/bUnderstandbPrimaryBrainTumors/AdditionalResources/CopingWithPersonalityBehavioralChanges/tabid/283/Default.aspx|title=Coping With Personality & Behavioral Changes|website=brainsciencefoundation.org|access-date=27 July 2016|url-status=live|archive-url=https://web.archive.org/web/20160730063637/http://www.brainsciencefoundation.org/bUnderstandbPrimaryBrainTumors/AdditionalResources/CopingWithPersonalityBehavioralChanges/tabid/283/Default.aspx|archive-date=30 July 2016}}</ref> A tumour in any of these lobes may affect the area's performance. The symptoms experienced are often linked to the location of the tumour, but each person may experience something different.<ref name=":22">{{Cite web|url=http://www.abta.org/brain-tumor-information/symptoms/mood-swings.html?referrer=https://www.google.com/ |title=Mood Swings and Cognitive Changes {{!}} American Brain Tumor Association |website=abta.org |access-date=27 July 2016 |url-status=dead |archive-url=https://web.archive.org/web/20160815110242/http://www.abta.org/brain-tumor-information/symptoms/mood-swings.html?referrer=https%3A%2F%2Fwww.google.com%2F |archive-date=15 August 2016 }}</ref> * [[Frontal lobe]]: Tumours may contribute to poor reasoning, inappropriate social behavior, personality changes, poor planning, lower inhibition, and decreased production of speech ([[Broca's area]]).<ref name=":22" /> * [[Temporal lobe]]: Tumours in this lobe may contribute to poor memory, loss of hearing, and difficulty in language comprehension ([[Wernicke's area]] is located in this lobe).<ref name=":1" /> * [[Parietal lobe]]: Tumours here may result in poor interpretation of languages, difficulty with speaking, writing, drawing, naming, and recognizing, and poor spatial and visual perception.<ref>{{Cite web|url=https://mayfieldclinic.com/pe-braintumor.htm|title=Brain Tumors: an introduction| vauthors = Warnick R |date=August 2018|website=Mayfield Brain and Spine Clinic}}</ref> * [[Occipital lobe]]: Damage to this lobe may result in poor vision or loss of vision.<ref>{{Cite web|url=https://www.thebraintumourcharity.org/understanding-brain-tumours/symptoms-and-information/changes-vision/|title=Changes in Vision β Brain Tumour Symptoms|website=thebraintumourcharity.org|access-date=9 February 2018|archive-url=https://web.archive.org/web/20180210002520/https://www.thebraintumourcharity.org/understanding-brain-tumours/symptoms-and-information/changes-vision/|archive-date=10 February 2018|url-status=dead}}</ref> * [[Cerebellum]]: Tumours in this area may cause poor balance, muscle movement, and posture.<ref name=":3">{{Cite web|url=https://www.chw.org/medical-care/macc-fund-center/conditions/oncology/brain-tumors|title=Brain Tumors|date=6 March 2019|website=Children's Hospital of Wisconsin}}</ref> * [[Brainstem|Brain stem]]: Tumours on the brainstem can cause seizures, endocrine problems, respiratory changes, visual changes, headaches and partial paralysis.<ref name=":3" /> * [[Leptomeninges]]: Tumours that spread to the leptomeninges, the lining of the brain, may cause [[cranial nerve palsies]] such as [[facial paralysis]], abnormalities of eye movement, abnormalities of facial sensation or [[dysphagia|swallowing difficulty]], depending on which cranial nerves are involved.<ref name="Schaff 2023">{{cite journal |last1=Schaff |first1=Lauren R. |last2=Mellinghoff |first2=Ingo K. |title=Glioblastoma and Other Primary Brain Malignancies in Adults: A Review |journal=JAMA |date=21 February 2023 |volume=329 |issue=7 |pages=574β587 |doi=10.1001/jama.2023.0023|pmid=36809318 |pmc=11445779 }}</ref> ===Behaviour changes=== A person's personality may be altered due to the tumor-damaging lobes of the brain. Since the frontal, temporal, and parietal lobes<ref name="abta.org"/> control inhibition, emotions, mood, judgement, reasoning, and behavior, a tumor in those regions can cause inappropriate social behavior,<ref name=":52">{{Cite web|url=http://milesforhope.org/index.php/facts/brain-tumor-symptoms|title=Brain Tumor Symptoms {{!}} Miles for Hope {{!}} Brain Tumor Foundation| vauthors = Jones C |website=milesforhope.org|access-date=3 August 2016|url-status=dead|archive-url=https://web.archive.org/web/20160814084958/http://milesforhope.org/index.php/facts/brain-tumor-symptoms|archive-date=14 August 2016}}</ref> temper tantrums,<ref name=":52"/> laughing at things which merit no laughter,<ref name=":52"/> and even psychological symptoms such as depression and anxiety.<ref name=":22"/> More research is needed into the effectiveness and safety of medication for depression in people with brain tumors.<ref>{{cite journal | vauthors = Beevers Z, Hussain S, Boele FW, Rooney AG | title = Pharmacological treatment of depression in people with a primary brain tumour | journal = The Cochrane Database of Systematic Reviews | volume = 2020 | pages = CD006932 | date = July 2020 | issue = 7 | pmid = 32678464 | pmc = 7388852 | doi = 10.1002/14651858.CD006932.pub4 }}</ref> Personality changes can have damaging effects such as unemployment, unstable relationships, and a lack of control.<ref name=":02" />
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