Do you often brush off recurring headaches, forgetfulness, or brief episodes of blurred vision as stress, lack of sleep, or a busy schedule? While these symptoms are usually linked to everyday causes, doctors say that in some cases they may point to a more serious underlying condition, including a brain tumour.

A brain tumour is an abnormal growth of cells within the brain or surrounding tissues. These tumours can be non-cancerous (benign) or cancerous (malignant), and are graded based on how quickly they grow and spread. Depending on their size and location, brain tumours can interfere with vital functions such as movement, speech, memory, vision, and behaviour. Although the exact cause of most brain tumours remains unknown, factors such as increasing age, exposure to radiation, and certain inherited genetic conditions may increase the risk.

The burden of brain tumours continues to grow worldwide. According to Global Burden of Disease 2021 estimates, the prevalence of brain and other central nervous system cancers has increased substantially since 1990. In India, data from the Global Cancer Observatory (GLOBOCAN) 2022 report ranks brain tumours as the 14th most common tumour type, with the number of cases projected to increase in the coming years.

Yet many people continue to overlook subtle warning signs, often attributing them to fatigue, stress, ageing, or common health issues. We spoke to Prof. Dr Satish Rudrappa, Group Director – Aster International Institute of Neurosciences and Spine Care, Aster Whitefield Hospitals, to understand the silent symptoms of brain tumours that people often ignore and when medical attention should not be delayed.

Why brain tumours are often difficult to spot

According to Dr Satish Rudrappa, brain tumours remain one of the most misunderstood neurological conditions because their symptoms often resemble common everyday problems such as stress, lack of sleep, migraine, hormonal changes, ageing, or anxiety.

He explained that symptoms depend largely on the tumour’s location, size, and growth rate. While some tumours progress slowly over months or years and produce vague symptoms, more aggressive tumours may cause noticeable neurological changes in a shorter period.

“Unlike a heart attack or a fracture, a brain tumour usually does not present dramatically. It often announces itself through subtle changes that gradually become more persistent. The problem is not only what people feel, but how long those symptoms remain unattended,” Dr Rudrappa said.

According to him, many patients seek medical attention only after symptoms begin interfering with their work, relationships, mobility, or daily routine, by which time the tumour may already be exerting pressure on nearby brain structures.

When headaches and vision problems should not be ignored

Headaches are among the most common symptoms associated with brain tumours, although Dr Rudrappa stressed that most headaches are not caused by brain cancer.

What concerns doctors, he said, is a headache that behaves differently from usual. Warning signs include headaches that progressively worsen over weeks or months, occur early in the morning, wake a person from sleep, are accompanied by vomiting or blurred vision, or stop responding to routine medications.

“For someone who has lived with migraines for years, a sudden change in the pattern, intensity, or character of headaches deserves medical attention,” he said.

Dr Rudrappa added that visual disturbances may also be overlooked because many people assume they simply need stronger glasses. However, tumours involving areas responsible for visual processing may lead to blurred or double vision, difficulty focusing, reduced peripheral vision, or episodes of visual confusion.

“In some cases, ophthalmologists are the first healthcare professionals to suspect an underlying neurological problem when routine eye examinations fail to explain these symptoms,” he said.

Seizures, balance problems, and weakness can be warning signs

According to Dr Rudrappa, a first-time seizure in adulthood should never be ignored. Contrary to popular perception, seizures do not always involve dramatic convulsions. They may appear as brief staring spells, sudden confusion, unusual smells or sensations, repetitive movements, temporary inability to speak, or involuntary jerking of an arm or leg.

“Many brain tumours are discovered when patients undergo investigations following their first unexplained seizure,” he said.

He further noted that persistent problems with balance and coordination may indicate involvement of the cerebellum, the part of the brain responsible for movement and coordination.

“People often attribute dizziness or unsteadiness to inner-ear disorders, low blood pressure, or cervical spine problems. But ongoing balance disturbances, particularly when accompanied by headaches or visual symptoms, should not be ignored,” he said.

Dr Rudrappa also cautioned that weakness, numbness, facial drooping, or difficulty using one side of the body may occur when tumours interfere with neural pathways controlling movement and sensation.

“Because these symptoms can resemble a stroke, they warrant urgent medical evaluation,” he said.

Personality changes and speech difficulties may appear gradually

Not all symptoms are physical. According to Dr Rudrappa, family members are sometimes the first to notice subtle changes in behaviour or cognition.

These changes may include irritability, lack of motivation, memory problems, poor concentration, emotional withdrawal, or difficulty performing familiar tasks.

“Tumours affecting the frontal lobe can alter behaviour, judgement, and emotional regulation. Since these changes develop gradually, they are often mistaken for stress, burnout, depression, or simply ageing,” he said.

He added that tumours involving language centres may make communication increasingly difficult.

“Occasionally forgetting a word is normal. Persistently struggling to find common words, understand conversations, read, write, or speak clearly is not,” Dr Rudrappa said.

Because such changes develop slowly, he explained, many people adapt to them without realising how much their abilities have changed.

Persistent symptoms deserve attention

Dr Rudrappa noted that nausea and vomiting without an obvious cause may also occur when rising pressure inside the skull interferes with the normal flow of brain fluid.

“Morning vomiting associated with headaches or visual disturbances should not be dismissed as a stomach problem. This combination requires prompt medical evaluation,” he said.

He emphasised that individual symptoms such as headache, dizziness, forgetfulness, or fatigue do not automatically indicate a brain tumour. The real concern arises when symptoms are persistent, progressive, unexplained, occur together, or begin affecting daily life.

“Perhaps the most important lesson is to trust persistent changes. Many patients later say they knew something wasn’t quite right but found explanations for each symptom individually. Often, it is not one symptom but a pattern of symptoms that tells the story,” Dr Rudrappa said.

According to him, a neurological examination and imaging studies such as MRI scans, when required, can help identify the underlying cause and guide treatment.