23. Neurological tumours and neurological complications of cancer and cancer treatment

Brain tumours can cause general symptoms (such as memory problems, lethargy) and focal symptoms (such as weakness, epilepsy). The most common primary brain tumours are low-grade and high-grade tumours that arise from glial tissue (gliomas). A second group consists of tumours originating in the cerebral meninges (meningiomas). Pituitary tissue tumours (pituitary adenomas) are less common, as are neuromas or schwannomas that arise from myelin-forming cells, usually around cranial nerves, nerve roots, or peripheral nerves. Brain metastases develop in 20 % of cancer patients. Leptomeningeal metastases are located in and around the cerebral meninges or the membranes surrounding the spinal cord. Intramedullary tumours (primary or metastases) are rare. Transverse lesions due to cancer-related spinal cord damage are caused mainly by a vertebral metastasis (or metastases) that spreads (spread) into the epidural space. Paraneoplastic neurological syndromes are rare. They often present as the first manifestation of cancer elsewhere in the body. This chapter deals with the various types of tumours that occur in, and adjacent to, the brain and spinal cord. This generally concerns tumour-related complications (sect. 23.1) and clinical symptoms (sect. 23.2). Next, we address solid tumours (sect. 23.3) and metastases (sect. 23.4 to sect. 23.6). The final part of this chapter deals with paraneoplastic symptoms and treatment complications (sect. 23.7). The various types of cancer treatment can cause complications (sect. 23.8). The final topic addressed here is the organization of neuro-oncological care (sect. 23.9). A knowledge of cerebral and spinal localization principles (Chaps. 4 to 7 and 15) and of the higher cerebral functions (Chap. 8) is essential for a proper understanding of this chapter. Brain tumours can (eventually) cause impairments of consciousness and a brain herniation syndrome (Chap. 20).