Astrocytoma Clinical Presentation

Updated: Mar 09, 2023
  • Author: Jeffrey N Bruce, MD; Chief Editor: Herbert H Engelhard, III, MD, PhD, FACS, FAANS  more...
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The type of neurologic signs and symptoms that result from an astrocytoma depends foremost on the site and extent of tumor growth in the central nervous system (CNS). Onset of any of the following should alert the clinician to the presence of a neurologic disorder and indicate a requirement for further investigation (in particular, with imaging studies such as magnetic resonance imaging [MRI] or computed tomography [CT] scan, with and without contrast):

  • Altered mental status
  • Cognitive impairment
  • Headaches
  • Visual disturbances
  • Motor impairment
  • Seizures
  • Sensory anomalies
  • Ataxia

Astrocytomas of the spinal cord or brainstem are less common. Patients with these neoplasms present with motor/sensory or cranial nerve deficits referable to the tumor's location.


Physical Examination

A detailed neurologic examination is required for the proper evaluation of any patient with an astrocytoma. Because these tumors may affect any part of the CNS, including the spinal cord, and may spread to distant regions of the CNS, a thorough physical examination referable to the entire neuraxis is necessary to define the location and extent of disease.

Special attention should be paid to manifestations of increased intracranial pressure (ICP), such as the following, to determine the risk of mass effect, hydrocephalus, and herniation:

  • Headache
  • Nausea and vomiting
  • Decreased alertness
  • Cognitive impairment
  • Papilledema
  • Ataxia

Localizing and lateralizing signs, including cranial nerve palsies, hemiparesis, sensory levels, alteration of deep tendon reflexes (DTRs), and the presence of pathological reflexes (eg, Hoffman and Babinski signs), should be noted. Once neurologic abnormalities are identified, imaging studies should be obtained for further evaluation.