Brain tumours arise from the normal constituents of the brain and its coverings (meninges). Spinal tumours are considered separately.
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Epidemiology
As a general rule, brain tumours increase in frequency with age, with individual exceptions (e.g. pilocytic astrocytoma, the vast majority of which are found in young patients), and a number of uncommon tumours found in infancy (see brain tumours of infancy). There are few gender differences, except that as a general rule, gliomas are more frequent in men and meningiomas are more frequent in women.
Clinical presentation
Ocular symptoms of intracranial space-occupying lesion are loss of vision, drooping of eyelids, double vision and protrusion of the eyeball. Ocular signs of intracranial space-occupying lesions are papilloedema and visual field defect 6.
Pathology
There are numerous individual tumour entities which come under the umbrella term "brain tumour" (see WHO Classification of CNS tumours). They can broadly be divided into:
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neuroepithelial (50% 1)
astrocytoma (44%)
ependymoma (3%)
medulloblastoma (3%)
oligodendroglioma (2%)
meningioma (15%)
metastases (15%)
pituitary tumours (8%)
primary CNS lymphoma (2.5%)
intracranial germ cell tumours 0.4% to 3.4% 4 (around the pineal, third ventricle or suprasellar region)
Another set of figures to ponder 5:
overall incidence: 5-13 cases per 100,000
incidence in children: 2-4 cases per 100,000
80% of all intracranial tumours are supratentorial
40% are metastases
70% of tumours in 1-year-olds to adolescents are in the posterior fossa
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