Medicine
Volume 36, Issue 11 , Pages 609-615, November 2008

Neurological oncology

Jeremy Rees PhD FRCP is a Consultant Neurologist at the National Hospital for Neurology and Neurosurgery, Queen Square, University College London (UCL) Hospital and Royal Marsden Hospital, London, UK, and Honorary Senior Lecturer in Medical Neuro-oncology at the UCL Institute of Neurology, London, UK. He qualified with Distinction from UCL Medical School in London and trained in general medicine and neurology in London. His research interests include low-grade gliomas and paraneoplastic neurological disorders. Competing interests: none declared

Abstract 

Neurological oncology is the study of brain and spinal tumours, and neurological complications of cancer. Primary brain tumours may occur anywhere in the brain, with supratentorial tumours being more frequent in adults and infratentorial tumours in children. Secondary tumours usually arise from lung cancer, breast cancer and melanoma. The most common presenting symptoms of a brain tumour are headache, seizures, confusion, progressive neurological deficit and cognitive decline. Surgery is indicated for curative resection of an extrinsic tumour, debulking of a large intrinsic tumour, relief of hydrocephalus and tissue diagnosis of an unresectable tumour. Radiotherapy is indicated as an adjunct to surgery in partially resected tumours at risk of recurrence or as primary treatment of malignant gliomas. Chemotherapy is indicated in a limited number of rarer tumours and concomitantly with radiotherapy for the primary treatment of glioblastoma multiforme. The prognosis of brain tumours is highly variable. Neurological complications of cancer are common and may occur either as a result of direct or metastatic tumour infiltration into the nervous system or as a complication of cancer therapy. Paraneoplastic neurological disorders are immune-mediated remote effects of cancer that may present before the primary tumour and cause serious neurological morbidity.

Keywords: brain tumour, chemotherapy, glioma, meningioma, metastasis, neurological complication of cancer, neurotoxicity, paraneoplastic neurological disorder, radiotherapy, surgery

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PII: S1357-3039(08)00241-7

doi:10.1016/j.mpmed.2008.08.005

Medicine
Volume 36, Issue 11 , Pages 609-615, November 2008