What role do neurological examinations play in the initial assessment of a patient suspected to have a primary brain tumour?

The role of neurological examinations in the initial assessment of a patient suspected to have a primary brain tumour is to identify progressive or sub-acute loss of central neurological function and any newly abnormal neurological signs that may indicate the presence of a brain tumour. This examination helps determine the urgency of further investigations such as an urgent MRI or CT scan, which should be performed within 2 weeks in adults with progressive neurological symptoms, or within 48 hours in children and young people with newly abnormal cerebellar or other central neurological function.

Neurological examination findings guide the decision to refer urgently or very urgently to specialist services and help prioritize imaging investigations. If there is uncertainty about symptoms or signs, discussion with a specialist is recommended to clarify the need for referral and communicate urgency.

Neurological examination also aids in identifying focal neurological deficits, which are critical in assessing the severity and localization of the suspected tumour. This initial clinical assessment is essential to ensure timely diagnosis and management of primary brain tumours.