Specific issues with brain tumours

This section deals with the symptoms that children with brain tumours or brain metastases may experience during this phase of care and how they can be managed.

Brain tumours can cause a variety of symptoms depending on which part of the brain is affected: no child will have all these problems.

Raised pressure in the brain

Brain tumours can cause raised pressure by:

  • Squashing the normal structures of the brain which may swell up as a result
  • Or by obstructing the normal fluid channels in the brain
  • If your child has a shunt, this may become blocked, and cause the pressure to go up

How do you know if your child has raised pressure?

  • This will usually cause a mixture of symptoms: typically, headache, vomiting (may be morning only, often still be able to eat) and excessive sleepiness
  • Sometimes, raised pressure also leads to double vision

What can you do?

  • Give anti-sickness medication
  • Give pain relieving medication for headache
  • Tell your nurse or doctor

What can your nurse or doctor do to help?

This will depend on the stage of the disease:

  • If your child has a shunt, it may need to be checked for blockage and repair
  • Symptom control: it may not be possible to reduce the pressure, but the symptoms can be improved with medication to keep your child comfortable (e.g. to control headaches and vomiting)

Dexamethasone

Dexamethasone is a steroid which can reduce swelling in tissues surrounding the tumour. It does not have an effect on the tumour but can reduce the symptoms of raised pressure

  • The benefits are only temporary, so it cannot be used continuously
  • It can be given for a few days to cover a special event
  • It has quite marked side effects but they are short lived if it is only taken for a few days at a time

Side effects of Dexamethasone

  • Stomach irritation and heartburn: an antacid can be prescribed
  • Constant hunger, weight gain and water retention: try frequent small portions
  • Mood changes: irritability, moodiness, depression, hyperactivity
  • Disturbance to sleep: mild exercise in the evening may help, if your child is able. Try giving the last dose at supper time
  • Skin problems: acne, stretch marks and hairiness can develop if steroids are taken for a longer time
  • Self image: weight gain and skin problems may affect your child’s appearance

Download or order our booklet 'Dexamethasone'  

Nausea and vomiting

  • In a child with a brain tumour, vomiting may be a sign of raised pressure: especially if your child vomits mainly in the morning, or vomits but continues to eat - please tell your nurse or doctor
  • Medication can be given by mouth but also by subcutaneous pump if your child can’t take oral medication

Fits

See our information about fits  

Loss of physical functions

The brain controls many functions such as speech and swallowing, vision, balance and walking etc. These controls are in different parts of the brain, so the effects of the tumour will depend on which part of the brain is affected.

Swallowing

Signs of difficulty:

  • Coughing or choking during or after eating or drinking
  • Pools of fluid or pockets of food in mouth, drooling
  • Your child may be afraid to eat and drink or avoid certain types or textures of food or drink
  • Frequent chest infections

What can you do to help?

  • You can try soft foods, pureed food or thickening food
  • Offer small portions more often

What can your nurse or doctor do to help?

  • A naso-gastric tube may help with medicines or fluids
  • They can give medicines to reduce secretions

Speech

Signs of difficulty:

  • Slurred speech, speaking in a whisper
  • Difficulty in finding or saying the right word

Ways to help:

  • Be patient, allow time for your child to speak
  • You may find communication aids helpful, e.g. picture board of common needs

Mobility and Balance

Signs of difficulty:

  • Your child may drag one leg when walking, or be unable to walk long distances, or tend to fall
  • He/she may wobble when standing
  • They may find it difficult to sit in a chair or on the toilet without falling

How can you help?

  • You can help your child by supporting them when they walk, holding hands or an arm
  • Let them walk indoors and short distances outside if they can and want to and use a wheelchair for longer distances
  • You may find it helpful to use a chair with sides

How can professionals help?

  • The occupational therapist will assess your child’s needs for specialist aids

Vision

Your child may have long-standing vision problems following the diagnosis of their brain tumour or they may develop visual symptoms during this time.

Signs of difficulty:

Develop a squint, complaining of double vision
Difficultly judging distances
Decreasing sight or loss of peripheral vision

Ways to help:

  • Use a patch over one eye
  • Glasses may help
  • Using large print books or a magnifying glass
  • Don’t approach your child from behind as this may scare then
  • Don’t rearrange the furniture in your house at this time
  • Don’t complain if your child sits very close to the TV