Diagnosis

Brain and spinal tumors are abnormal growths in or around the spinal column and brain. They can destroy healthy cells or inhibit normal function. The cause of most brain and spinal tumors is unknown.

Our neuro-oncology specialists conduct many different tests to diagnose and evaluate brain and spinal cord conditions. Your doctor will complete a thorough physical exam and talk with you about your symptoms and your medical history.

Symptoms Of Brain And Spine Tumors

Brain and spinal tumors can begin in the brain and spine, or they can spread to the brain and spine from other cancers in other parts of the body. Symptoms depend on the location and type of tumor.

Brain tumors impact normal brain activity, increase pressure in the brain, and damage nerves and healthy tissue. Symptoms can include:

  • Blood clots
  • Changes in behavior or thinking
  • Changes in hormone levels
  • Depression
  • Fatigue
  • Headaches
  • Hearing or vision loss
  • Speech problems
  • Loss of touch
  • Difficulty walking or balance
  • Loss of movement control
  • Nausea and vomiting
  • Speech problems
  • Seizures

Spine tumors can form in the spinal cord, nerves, or membranes of the spinal cord. Symptoms may include:

  • Cold sensations in your legs, knee, ankle, hands, or fingers
  • Muscle weakness, especially in your legs
  • Loss of touch
  • Difficulty walking or balance
  • Loss of movement control
  • Pain in the middle or lower back that does not improve with pain medication and is worse when you lie down, cough or sneeze

Diagnosing Brain And Spine Tumors

To determine the type, location, shape, and size of a tumor, your specialist may order a variety of diagnostic tests, including clinical tests and advanced neuroimaging. Tests to diagnose and locate a brain or spinal tumor may include:

  • CT (computed tomography). X-rays and computer technology combine to form a picture of the brain.
  • CT myelography. Takes images of the spine for tumors.
  • CT angiography (CTA). Provides better details of the blood vessels in and around a tumor.
  • MR angiography (MRA). A special type of MRI that looks at the blood vessels in the brain.
  • MRI spectroscopy. This imaging test measures biochemical changes in an area of the brain, displayed in graph-like results called spectra. The type of tumor, or how quickly it is likely to grow, can sometimes be identified.
  • fMRI (functional MRI). This type of MRI determines what part of the brain handles a function, such as speech, thought, sensation, or movement. 
  • MRI perfusion. An MRI that shows the amount of blood going through different parts of the brain and tumor. Tumors often have a bigger blood supply than normal areas of the brain.
  • MRI diffusion tensor – tracktography. Images created by MRI and diffusion MRI measure the rate of water diffusion between cells to create a map of the body’s internal structures. The images combine to form 2D and 3D pictures called tractograms.
  • PET (positron emission tomography)/CT. A type of nuclear medicine imaging that uses small amounts of radioactive material to diagnose and evaluate a tumor. The nuclear medicine images are superimposed with the CT images, allowing the doctor to correlate and interpret information from two different exams on one image for more precise diagnosis.

Tests to diagnose and locate a spinal tumor include:

  • Lumbar puncture. A thin needle inserted into the space around the spinal column removes a sample of cerebrospinal fluid to measure the red and white blood cell count and check for signs of cancer.
  • CT (computed tomography)
  • MRI (magnetic resonance imaging)
  • Spine X-ray

The neurosurgeons, neurologists, radiation oncologists and other professionals on your care team will review your test results and use them to recommend the best treatment options for you.

Types Of Brain And Spine Tumors

There are benign tumors and malignant tumors. Benign tumors are non-cancerous and develop slowly. Malignant tumors are fast growing, cancerous tumors that can spread to other parts of the body.

Primary brain tumors begin in the brain and usually do not spread to other parts of the body. They do often spread to other parts of the brain. Glioblastoma is the most common primary brain tumor in adults.

Secondary brain tumors are malignant tumors that spread from other parts of the body, such as lung cancer that is found in the brain.

Types of brain and spine tumors include:

  • Gliomas. This is the most common type of brain tumor. Gliomas form in the supportive glial cells. Some types of gliomas are fast-growing; others grow slowly. Gliomas include:
    • Astrocytoma. A tumor that forms in the star-shaped cells called astrocytes. Astrocytomas often spread into healthy tissue.
    • Oligodendroglioma. These tumors form in the cells that make the white protective shield that surrounds nerves (myelin) and often spread into nearby brain tissue.
    • Ependymomas. These tumors form in the lining of the fluid-filled spaces (ventricles) of the brain. Ependymomas do not usually spread.
    • Mixed gliomas. These tumors include more than one type of glial cell, such as astrocytes and oligodendrocytes.
    • Ganglioglioma. This is a rare tumor that forms in the brain or spine. It forms from glial and nerve cells.
    • Glioblastoma. Also called a GBM (glioblastoma multiforme), this is the most common form of brain tumor in adults. Glioblastomas are fast growing and often spread into nearby tissue.
  • Meningiomas. A type of brain tumor that starts in the outer lining of the brain.
  • Medulloblastoma. A brain tumor that forms in the back of the brain (cerebellum) that controls balance and coordination.
  • Schwannomas. A tumor that forms in the myelin-making cells that surround the nerves. It occurs most often in the vestibular nerve of the inner ear.
  • Craniopharyngioma. This non-cancerous brain tumor forms near the pituitary gland.
  • Pituitary tumors. Tumors can form in the pituitary gland, at the base of the skull. Most pituitary tumors are benign but they can press on optic nerve and cause vision problems. Pituitary tumors can also cause higher or lower levels of hormone production.
  • Chordomas. A rare type of bone cancer that forms at the base of the skull and can affect nerves that control the face, eyes and swallowing.
  • Non-Hodgkin’s Lymphoma. Cancer that forms in the lymphatic system and can form tumors in the brain and spine.
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