BRAIN
Brain Tumor
Not every tumor is malignant and not every tumor requires surgery. The evaluation defines the path.
Book an evaluationMRI scan of the brain in axial view
Dr. Victor BatistelaNeurosurgeonCRM-PR 35044 · RQE 30580 (Brazilian medical registration)
Most common types
Tumor is one name for many different things
A brain tumor is an abnormal growth of cells inside the skull. There are many types, with very different behaviors. Some grow slowly and may simply be monitored for years; others call for treatment within weeks.
Gliomas arise from the brain tissue itself and vary widely in behavior. Meningiomas arise from the membranes that surround the brain and, in a good proportion of cases, are benign. Metastases are cells from a cancer elsewhere in the body that have reached the brain.
The first step after a finding on imaging is to understand which tumor it is, where it is and how it behaves. That answer defines everything else.
- Glioma — from the brain tissue
- Meningioma — from the membranes; often benign
- Metastasis — from a cancer of another origin
Anatomy
Each region handles a function
It is the location of the tumor, more than its size, that explains the symptoms and guides the planning.
- 1
Frontal lobe
Movement, planning, behavior and part of speech.
- 2
Parietal lobe
Body sensation and spatial awareness.
- 3
Temporal lobe
Hearing, memory and language comprehension.
- 4
Occipital lobe
Vision.
- 5
Cerebellum
Balance and coordination of movements.
Symptoms
What usually draws attention
Symptoms depend on the region affected and the speed of growth. The most common are a new headache or one different from the usual, especially if it worsens on waking; a seizure, above all the first one in an adult; changes in vision, speech, strength or balance; and a change in behavior or memory noticed by the family.
None of these signs, on its own, means a tumor. Headaches are very common and almost always have other causes. What deserves evaluation is a new neurological symptom that persists or progresses.
When not to wait
Signs that call for the emergency room
These signs call for the emergency room, not an elective appointment.
- a seizure for the first time
- weakness, numbness or loss of speech of sudden onset
- severe headache with vomiting and drowsiness
- altered consciousness after head trauma
How the evaluation is done
From imaging to plan, as a team
Cases of tumors of the nervous system are discussed as a team. At the Hospital do Câncer de Londrina, this discussion takes place in the neuro-oncology outpatient clinic, coordinated by Dr. Victor Batistela.
Step 01
Clinical evaluation
History and neurological examination relate the symptoms to a region of the brain.
Step 02
MRI
With contrast, it shows the size, location and the tumor's relationship with speech and motor areas. Additional tests in selected cases.
Step 03
Multidisciplinary discussion
Neurosurgery, oncology, radiation oncology, neurology and radiology assess the case together.
Step 04
Definition of the plan
Observe, biopsy, surgery, radiation therapy or medication — and long-term follow-up.
When surgery may be considered
Remove as much as is safe
Surgery can have three goals: to obtain a diagnosis (biopsy), to reduce the volume of the tumor to relieve pressure and symptoms, and to remove the tumor as completely as is safe. The key word is safe: the goal is to remove as much as possible while preserving speech, movement, vision and memory.
To that end, planning uses the images to map the tumor's relationship with critical areas, and the surgery may rely on neuronavigation and monitoring of functions during the procedure. In selected cases, when the tumor is close to language or motor areas, awake brain surgery is used: the person answers simple tests while the team operates. A surgery of this kind, performed at the Hospital do Câncer de Londrina, was the subject of a G1 Paraná report in July 2026.
Two paths
Monitor, treat without operating or operate
Follow-up and other therapies
- Observation with follow-up MRIs, in slow-growing tumors without symptoms
- Radiation therapy, including focused techniques such as radiosurgery
- Chemotherapy and other drug therapies, according to the type of tumor
- Rehabilitation (physical therapy, speech therapy, occupational therapy) when there is function to recover
Surgery
- Biopsy, when the type of tumor needs to be defined before treatment
- Volume reduction to relieve pressure and symptoms
- Removal of the tumor, as completely as is safe
- Always followed by long-term follow-up with control imaging
Not every tumor is operated on. The indication depends on the type, the location, the symptoms and each person's general condition.
Frequently asked questions
- No. Many brain tumors are benign, like a good proportion of meningiomas. Benign does not mean it can be ignored — the tumor can still cause symptoms through the space it occupies — but it changes how it is treated and monitored.
- In the vast majority of cases, no. Headaches are very common and almost always have other causes. What draws attention is a new, persistent pain that worsens on waking, accompanied by vomiting, changes in vision, weakness or seizure.
- It is a technique used in selected cases, when the tumor is close to areas responsible for speech or movement. During part of the procedure the patient remains awake and answers simple tests, which allows the team to monitor these functions in real time.
- Follow-up is done as a team: neurosurgeon, oncologist, radiation oncologist and other specialists, according to the type of tumor. At the Hospital do Câncer de Londrina, this discussion takes place in the neuro-oncology outpatient clinic.
- It is not mandatory, but if you already have tests and reports, bring them. If you were referred by another doctor, their report helps in understanding what has already been investigated.
Read also
Book an evaluation
The appointment serves to understand the condition and define the next step. Not every condition requires surgery.
This channel is not a substitute for emergency care. In an emergency, go to the nearest emergency room.
