Physical examination

To investigate the possibility of a brain tumour, your doctor may do a physical examination. This may include tests such as:

• checking your reflexes
• testing the strength in your arm and leg muscles
• walking in a line to show your balance and coordination
• testing whether you can feel a pinprick
• brain and memory exercises
• examining your eyes, and also your eye movements.

If these tests show that you may have a tumour, or if your doctor wants to rule out a tumour as the cause for your symptoms, other tests may be suggested.

Diagnostic tests

Tests to diagnose brain tumours include imaging or scans that allow doctors to ‘see’ inside your brain, such as:

• a CT (computerised tomography) scan – this uses X-ray beams to take multiple pictures of the inside of your body
• an MRI (magnetic resonance imaging) scan – this uses magnetism and radio waves to create detailed cross-sectional pictures of your body

You may also have blood tests to check hormone levels.

Other tests show how serious your tumour is or how quickly it’s growing. This is called the ‘grade’ of your tumour.

Tests to show the grade of your tumour include:

• PET (positron emission tomography) scan
• spinal tap (also called lumbar puncture) to collect a sample of cerebrospinal fluid (fluid around your brain and spinal cord)
• surgical biopsy, in which a small piece of brain tissue is removed under anaesthetic to be examined
• angiogram – to examine the blood supply to the area being scanned, especially when a tumour may be deep inside the brain.

Grading brain tumours

Brain tumours are usually given a grade from 1 to 4, based on how abnormal their cells appear when looked at with a microscope, and how quickly the tumour is growing:

• grades 1 and 2 – low-grade tumours, growing at a slow rate
• grade 3 – high-grade tumours, growing at a moderate rate
• grade 4 – fastest growing, also called high-grade tumours.