Symptoms that need evaluation
Brain tumours are uncommon, and most headaches have a benign cause. Features that raise concern include a new persistent headache that is worse in the morning or with coughing, vomiting without another explanation, a first seizure, progressive weakness or numbness, double vision, visual field loss, hearing change, unsteadiness or a change in personality and memory.
Symptoms depend on the tumour's location and growth rate. A slow-growing tumour may cause subtle changes over months, while a rapidly growing lesion can present with seizures or raised pressure. The evaluation is not a single test; it combines history, neurological examination and imaging.
- New persistent headache with vomiting or morning worsening
- First seizure or unexplained blackout
- Progressive weakness, numbness or speech difficulty
- Vision, hearing or balance change
- Personality, memory or behaviour change
Related: Neurology → · Dr. Jitendra Knowledge Hub → · ICHD-3 Topic →
What the assessment covers
Dr. Yadav reviews the timeline, headache pattern, seizure history, steroid or anticoagulant use, cancer history and family history. Examination includes fundoscopy, visual fields, cranial nerves, power, sensation, coordination and gait. MRI or CT is reviewed directly, not just from the report.
If imaging shows a lesion, the next step is to determine whether it needs urgent neurosurgical review, a biopsy, further imaging or observation. Not every lesion is a tumour; abscess, stroke, demyelination, aneurysm and pituitary lesions can mimic one. Blood tests and sometimes lumbar puncture or EEG are used when the differential includes infection, inflammation or seizures.
| Finding | Possible next step |
|---|---|
| New focal deficit or reduced consciousness | Urgent emergency department assessment and imaging |
| First seizure with a lesion | Neurosurgical referral and seizure management |
| Incidental stable lesion | Specialist imaging review and planned follow-up |
| Pituitary hormone symptoms | Endocrinology and neurosurgery coordination |
Treatment and coordination
The neurologist's role is to evaluate the symptom, stabilise seizures or raised pressure when appropriate, explain the imaging, and coordinate referral to neurosurgery, neuro-oncology, radiation oncology or endocrinology. Treatment may include surgery, radiotherapy, chemotherapy, targeted therapy or observation, depending on the tumour type and grade.
After treatment, follow-up addresses seizure control, steroids, fatigue, cognitive change, mood, rehabilitation and return to work. A second opinion is reasonable when the diagnosis or plan is unclear. The clinic does not claim to provide neurosurgery or radiotherapy on site; the value is accurate assessment and a clear, timely referral pathway.
Access and booking
Appointments are at Kathmandu Neurology Clinic & Cognitive Center, 117 Lal Durbar Marg, Kathmandu, opposite Yak & Yeti Hotel. Call +977-9747736624 or use /book-appointment. Bring prior reports, imaging, seizure or symptom records and a medication list. Neurophysiology tests are arranged at an affiliated laboratory or hospital when indicated; the consultation confirms whether the test is appropriate and explains the result.