Symptoms of Hemangioblastoma

Hemangioblastomas are rare, noncancerous (benign) tumors that commonly occur in the cerebellum of the brain, but can also form in the spinal cord and retina (back of the eye). These tumors originate from cells lining blood vessels and their specific location and size significantly influences the severity of symptoms experienced by each patient.

Hemangioblastomas account for roughly 0.5% of all primary brain tumors and 2% of spinal tumor diagnoses. They can present at any age, though the majority of cases are diagnosed between the ages of 20 and 50.

Although hemangioblastomas are typically slow-growing and benign, their presence can lead to significant neurological deficits if they invade critical structures in the brain or spine.

Timely diagnosis can lead to better outcomes and help prevent the progression of potential neurological deficits. It is essential for patients and their families to be aware of possible signs and seek prompt medical care when symptoms arise.

Hemangioblastomas are benign tumors that originate from blood vessels in the central nervous system. These tumors can occur sporadically or as part of a genetic condition known as von Hippel-Lindau (VHL) syndrome, which predisposes individuals to the risk of multiple tumor formations.

The presence of hemangioblastomas in the brain, brainstem, or spinal cord can lead to a range of neurological symptoms due to their impact on the complex network of nerves in these areas.

As these tumors grow, they can compress nearby structures and disrupt normal blood or cerebrospinal fluid (CSF) flow. This restriction can exert pressure on nerves, impair blood flow, and cause localized swelling.

Interruptions to blood or CSF supply may cause headaches and nausea, among other problems. The gradual growth of hemangioblastomas means symptoms often develop slowly and can initially go unnoticed.

In fact, many cases are incidentally discovered during imaging for unrelated conditions. If you or someone you know is experiencing any changes in neurological function, it's crucial to seek prompt medical attention. Early diagnosis and treatment can help manage symptoms and improve quality of life.

The symptoms of hemangioblastomas can be diverse and often depend on the tumor's specific location within the central nervous system.

A cerebral hemangioblastoma occurs in the upper portion of the brain and the symptoms it causes depends on exactly where in the brain the tumor is located.

• Vision problems: If the tumor grows on your retina, it can cause blurred vision, eye pain and swelling and retinal detachment.
• Weakness: A tumor pressing on areas that control muscle motor function can lead to weakness in the limbs.
• Speech difficulties: Tumors affecting language regions of the brain can lead to difficulties in speaking or understanding speech.
• Cognitive difficulties: If the tumor impacts areas responsible for cognition, there may be issues with memory, concentration, or other executive functions.

The cerebellum, located on the underside of the brain, is a special structure responsible for coordinating movement and maintaining balance.

Early signs of cerebellar hemangioblastomas, sometimes referred to as cerebellar hemangioblastoma syndrome, include dizziness and difficulty with fine motor skills.

As the tumor grows, these symptoms can escalate to more severe problems such as vomiting, difficulty walking, and changes in speech due to increased pressure on surrounding structures. Notable symptoms of cerebellar hemangioblastoma can include:

• Headaches: The tumor can increase pressure inside the skull, causing persistent headaches.
• Dizziness and balance issues: As the cerebellum is integral for balance, a tumor in this area can cause unsteadiness or a sensation of spinning.
• Coordination problems: Difficulty with tasks like writing or buttoning a shirt may occur due to impaired fine motor coordination.
• Nausea and vomiting: Increased pressure from the tumor can stimulate areas of the brain that trigger nausea.

The brainstem and spinal cord contain nerves that are critical for transmitting signals between the brain to the rest of the body. A hemangioblastoma in these areas can compress important nerves, leading to a range of symptoms in the face and body.

• Back pain: These tumors can cause local pain or discomfort in the spine.
• Sensory changes: Numbness or tingling sensations can occur in the body if essential nerves that carry sensory information are compressed.
• Weakness or paralysis: If the mass affects motor pathways, it can lead to muscle weakness or even paralysis.
• Bowel and bladder dysfunction: In some cases, the tumor can cause constipation or bladder incontinence if it compresses nerves related to digestive functions.

• Hemangioblastomas are benign tumors that can cause a range of symptoms based on their location in the central nervous system (brain and spinal cord).
• Cerebellar hemangioblastomas typically lead to headaches, dizziness, and coordination problems, while brainstem and spinal cord hemangioblastomas can cause more complex neurological symptoms throughout the rest of the body.
• Symptoms may include difficulty with balance, swallowing, facial numbness, double vision, back pain, sensory changes, and muscle weakness.
• Many hemangioblastomas are asymptomatic and discovered incidentally, but symptomatic tumors can significantly affect quality of life.
• Early detection and treatment are crucial, so it's important for patients and caregivers to be aware of these symptoms and seek medical evaluation if they arise.

• National Institutes of Health (NIH): Hemangioblastoma
• Cancer Research UK: Hemangioblastoma
• American Brain Tumor Association (ABTA): Hemangioma
• VHL Alliance