Brain Metastases Symptoms

The symptoms of brain metastases can be very different from person to person. They depend on where the tumor is in the brain, how fast it is growing, and how much pressure it causes inside the skull. Brain tumors can:

• Invade and destroy brain tissue that may be responsible for critical functions like vision or speech.
• Put pressure on nearby tissue.
• Take up space and increase pressure within the skull (intracranial pressure).
• Cause fluids to accumulate in the brain.
• Block normal circulation of cerebrospinal fluid through the spaces within the brain.

Brain tumor signs and symptoms

Brain tumor symptoms often depend on where the tumor develops. In many cases, the symptoms below appear early in the tumor’s development. Other times the same symptom can be caused by more advanced disease. Brain tumor symptoms include: 

• Headaches. A headache due to a brain tumor usually becomes more frequent as time passes. It may not get better with over-the-counter pain medicine.
• Nausea or vomiting, especially with headaches.
• Changes in mood or behavior. You may become withdrawn, moody or inefficient at work. You may feel drowsy, confused and unable to think. Depression or anxiety, especially if either develops suddenly, may be an early symptom of a brain tumor. You may become uninhibited or behave in ways you never have before.
• Problems thinking clearly, remembering things or focusing
• Trouble speaking or finding the right words
• Seizures. Seizures can take many different forms, such as numbness, tingling, uncontrollable arm and leg movements, difficulty speaking, strange smells or sensations, staring and unresponsive episodes or convulsions.
• Worsening headaches, especially when you lie down, bend over or bear down, such as when you have a bowel movement
• Changes in vision, such as double or blurry vision. You may develop peripheral vision loss that causes you to not see things on the “blind side.”
• Hearing or smelling problems
• Loss of balance or trouble walking
• Weakness or numbness in parts of the body
• Loss of coordination or control over movements
• Change in the ability to feel heat, cold, pressure, a light touch or sharp object.

Conditions with similar symptoms

These symptoms may not mean you have brain cancer. Other conditions that share some of these symptoms include:

• Migraines or chronic headaches
• Seizure disorders like epilepsy
• Stroke
• Multiple sclerosis (MS)
• Mental health conditions such as depression or anxiety
• Infections, including meningitis or encephalitis
• Neurodegenerative diseases, like Alzheimer’s or Parkinson’s.

Because many of these symptoms can be caused by different conditions, only imaging tests (like an MRI or CT scan) can confirm whether a tumor is present. Other tests can be performed such as an EEG (for seizures) and a lumbar puncture (spinal tap) to assess leptomeningeal disease and other conditions such as multiple sclerosis and infection (e.g., meningitis or an abscess).

What do brain metastases feel like?

A brain tumor doesn’t cause pain directly, but it can cause symptoms as it presses on nerves or disrupts brain tissue. 

Common signs include persistent headaches (often worse in the morning), nausea, vomiting, seizures, weakness or numbness in parts of the body and difficulty with balance or coordination. Fatigue and confusion are also possible. 

Symptoms vary depending on the tumor’s size and location. While these issues can have other causes, any new, worsening or unexplained neurological symptoms should be evaluated by a health care provider.

When to see a doctor

Cancer patients who notice new symptoms should contact their care team right away. Their care team will conduct examinations and order tests to check for brain metastases. If a brain metastasis is discovered, the care team will promptly refer the patient to a cancer doctor who specializes in treating brain tumors, including a neurosurgeon, neuro-oncologist and/or a brain radiation oncologist.