Common symptoms of brain tumours
Brain tumour symptoms depend on tumour size, location, rate of growth and surrounding oedema. Headache is present in approximately 50% of patients at diagnosis, but most chronic headaches are not caused by tumours. Tumour-associated headache is typically progressive (worsening over weeks), worse in the morning (due to raised intracranial pressure from lying flat overnight), aggravated by coughing, straining or Valsalva manoeuvre, and may be accompanied by nausea and vomiting. Progressive headache that is new, different from previous headaches, or worsening despite treatment warrants investigation.
Seizures are the presenting symptom in approximately 20–40% of brain tumour patients. A new seizure in an adult over 25 without prior history is a red flag requiring neurological evaluation and imaging. Focal symptoms reflect the affected brain region: weakness or numbness on one side (contralateral motor or sensory cortex), speech difficulty (dominant hemisphere — typically left, Broca's or Wernicke's area), visual field cut (optic pathway or occipital lobe), personality or behavioural change (frontal lobe), memory decline (temporal lobe), gait disturbance (frontal lobe or cerebellum), and cranial nerve palsies (brainstem or skull base). Raised intracranial pressure may produce papilloedema (swelling of the optic disc), double vision (from sixth nerve palsy), and drowsiness.
- Progressive morning headache, worse with coughing or straining
- New seizure in adult over 25 — red flag requiring imaging
- Focal weakness or numbness on one side
- Speech difficulty — Broca's or Wernicke's aphasia
- Personality or behavioural change — frontal lobe involvement
- Visual field cut or double vision — optic pathway or brainstem
Related: Neurologist Kathmandu → · Dr. Jitendra Knowledge Hub → · ICHD-3 Topic →
When to seek urgent evaluation
Urgent neurological evaluation is needed when headache is progressive over days to weeks (especially morning headache with vomiting), when a new seizure occurs in an adult, when focal neurological symptoms develop (weakness, numbness, speech difficulty, visual change), or when personality or cognitive change is progressive. These symptoms do not necessarily indicate a tumour — stroke, infection, demyelination and autoimmune conditions can produce similar presentations — but they all require investigation to establish the cause.
Evaluation at Kathmandu Neurology Clinic begins with structured neurological history and examination, assessing the pattern and tempo of symptom progression, focal neurological signs and red-flag features. Brain MRI with gadolinium contrast is the investigation of choice for suspected intracranial mass. Referral for urgent imaging and, if a mass is identified, neurosurgical and oncological assessment follows the appropriate pathway. Dr. Jitendra Prasad Yadav (NMC 8029) provides initial evaluation, investigation planning and onward referral at Kathmandu Neurology Clinic & Cognitive Center, Durbar Marg, Opposite of Yak & Yeti Hotel. The clinic does not provide tumour treatment directly but ensures appropriate specialist referral when intracranial masses are identified.
- Progressive headache with morning vomiting — urgent evaluation
- New seizure in adult over 25 — brain MRI recommended
- Progressive focal weakness, numbness or speech difficulty
- Progressive personality or cognitive change
- Referral for neurosurgical and oncological assessment when mass identified